Benefi t of Platinum-based Chemotherapy in Metastatic Triple Negative Breast Cancer

Background: Management of triple-negative breast cancer (TNBC) is challenging because of a lack of targeted therapy, its aggressive behavior and its relatively poor prognosis. Various studies showed that these tumors are highly chemosensitive and in some cases are represented by complete pathological response (pCR), but the results remains unsatisfactory.1 Recent experimental data strongly suggest that platinum-based chemotherapy (PBC) could improve the outcome of TNBC, but clinical data are still lacking.4 Objective: To evaluate the benefi t of addition of platinum agents to metastatic TNBC therapy. Method: Several databases were searched. Comparative studies were identifi ed using the following keywords: triple negative breast cancer, advanced, metastatic, metastases, platinum agents, cisplatin, and carboplatin. The search was not limited to controlled or randomized trials. The limitations used in searching the articles are human, english, and 5-year maximum of publication. Articles were reviewed by two authors and selected if they described advanced triple negative breast cancer, use of platinum agents, and outcome. Results: Seven studies were included. Median survival of metastatic TNBC patients treated with PBC was 10.4 to 32.8 months. There was a signifi cant survival benefi t compared to non-PBC treated patients with overall survival 7.5 to 21.5 months. However PBC did not show signifi cant diff erent benefi t between TNBC and non-TNBC patients. Conclusion: PBC demonstrated not only higher response rate but also remarkable improvement in PFS and OS. It is still premature to draw a conclusion on survival advantage merely from phase II trials, but for this subtype, platinum agents had extra clinical benefi t compared to other agents.