Platinum agents in the treatment of early-stage triple-negative breast cancer: is it time to change practice?

Triple-negative breast cancer (TNBC) carries a higher risk of distant recurrence and death in the first 5 years compared with other types of breast cancer. Owing to the largely heterogeneous nature of TNBC, no unifying alteration exists that could benefit from a specific targeted therapy. A subset of TNBC, however, has intrinsic genomic instability caused by deficient DNA repair that could lead to the success of platinum agents (cisplatin or carboplatin) in treatment. Clinically, the addition of platinum agents to neoadjuvant treatment of TNBC is clearly associated with significantly higher rates of pathologic complete response. The utility of platinum agents in addition to standard adjuvant or neoadjuvant chemotherapy remains controversial, however, because data on overall survival and disease-free survival are not available. It remains unclear whether the addition of platinum agents to neoadjuvant chemotherapy improves long-term outcomes of TNBC.