Triple-negative breast cancer (TNBC) is a subtype of breast cancer which lacks receptors for progesterone, estrogen, and human epidermal growth factor receptor 2. Recent clinical trials have shown that the combined treatment using platinum agents with neoadjuvant chemotherapy (medicines administered before the surgery) can be very successful. This literature review analyzes the efficacy and safety of this treatment.
Data was collected from primary articles published in ESMO and PubMed, by searching with the terms “triple negative breast cancer,” “neoadjuvant chemotherapy,” and “platinum agents.” Randomized controlled trials, systematic review, and meta-analyses were studied. Of the 20 sources found, seven were relevant to the objective of this study and were included in this review.
It was found that the addition of platinum agents to neoadjuvant chemotherapy shows an increase in pathological complete response. However, no data shows a statistically significant difference in the overall survival and response rate. Several cohort clinical trials report that the platinum-based neoadjuvant chemotherapy performs better on BRCA1/2 mutant TNBC patients than on BRCA1/2 wild-type TNBC patients. Toxicities may occur when including the platinum, but they are controllable and do not affect the treatment delivery. The main two side effects are febrile neutropenia (fever in patients with neutropenia) and thrombocytopenia (low blood platelets).
Even though platinum-based neoadjuvant chemotherapy causes some side effects, its potential benefits are vast and outweigh the adverse events. However, more research must still be conducted to clarify the efficacy, and to establish a safe dosage of the platinum-based neoadjuvant chemotherapy for TNBC.