Platinum-Based Neoadjuvant Chemotherapy for Breast Cancer With BRCA Mutations: A Meta-Analysis.

Abstract

BACKGROUND:

Triple-negative breast cancer (TNBC) is one of the most aggressive subtypes of breast cancer and the major phenotype of BRCA related hereditary breast cancer. Platinum is a promising chemotherapeutic agent for TNBC. However, its efficacy for breast cancer with BRCA germline mutation remains inconclusive. Here we present a meta-analysis to evaluate the effect of platinum agents for breast cancer patients with BRCA mutation in neoadjuvant setting.

MATERIALS AND METHODS:

Pubmed, Embase, and Cochrane Central Register of Controlled Trials databases were searched for relevant studies on neoadjuvant platinum treatment and BRCA related breast cancer. Fixed- and random-effect models were adopted for meta-analyses. Heterogeneity investigation was conducted by sensitivity and subgroup analyses. Publication bias was evaluated by funnel plot and Begg's test.

RESULTS:

In all, five studies with 363 patients were included for meta-analysis. The pooled pathological complete response (pCR) rates were 43.4% (59/136) and 33.9% (77/227) for platinum and control groups, respectively. Adding platinum to neoadjuvant regimen did not significantly improved pCR rate (odds ratio [OR]: 1.340, 95% confidence interval [CI] = 0.677-2.653, p = 0.400). Sensitivity analyses also revealed platinum did not significantly increase pCR rate in either TNBC or HER2- patients (TNBC subgroup: OR: 1.028, 95% CI = 0.779-1.356, p = 0.846; HER2- subgroup: OR: 0.935, 95% CI = 0.716-1.221, p = 0.622).

CONCLUSIONS:

Our meta-analysis suggested that the addition of platinum to neoadjuvant chemotherapy did not significantly improve pCR rate for patients with BRCA mutations. Further large-scale randomized control trial with survival data may provide more robust evidence on therapeutic value of platinum for breast cancer neoadjuvant treatment.

• Authors: Chang-Jun Wang, Ying Xu, Yan Lin, Han-Jiang Zhu, Yi-Dong Zhou, Feng Mao, Xiao-Hui Zhang, Xin Huang, Ying Zhong, Qiang Sun, Cheng-Gang Li
• Journal: Frontiers in oncology (Front Oncol) Vol. 10 Pg. 592998 ( 2020) ISSN: 2234-943X [Print] Switzerland
• PMID: 33304851 (Publication Type: Systematic Review)
• Copyright: Copyright © 2020 Wang, Xu, Lin, Zhu, Zhou, Mao, Zhang, Huang, Zhong, Sun and Li.