Platinum‐containing chemotherapy for women before or after s | Figure 1
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Platinum‐containing chemotherapy for women before or after surgery for early triple‐negative breast cancer
Key messages
Chemotherapy including the platinum‐based medicine carboplatin improves survival and reduces the chance of cancer returning for people with early triple negative breast cancer.
However, it is also associated with increased side effects.
What is triple‐negative breast cancer?
Triple‐negative breast cancer makes up 15% of breast cancer cases. It is a type of breast cancer that does not have any of the three receptors commonly found on breast cancer cells – the oestrogen, progesterone and HER2 receptors. Early breast cancer is defined as cancer limited to the breast and lymph nodes in the armpit, and it can usually be cured.
What did we find?
We found 20 studies that involved 4688 people with early triple‐negative breast cancer, with average follow‐up in studies ranging from three to eight years.
Platinum chemotherapy was associated with longer disease‐free survival and overall survival, and reduced the chance of disease recurrence and death by about one third. These benefits were seen with chemotherapy used before surgery (neoadjuvant) or after surgery (adjuvant). When used before surgery, it also improved the likelihood of a pathological complete response.
We did not find that any particular subgroup, such as people with a high‐risk gene mutation, had more benefit from platinum chemotherapy.
However, people receiving platinum chemotherapy were more likely to need the dose of their chemotherapy to be reduced, or to have a delay in their chemotherapy. They were also more likely to stop chemotherapy early.
Platinum chemotherapy also caused more serious side effects including low blood cell counts. It was not associated with an increase in having fevers associated with low white blood cell counts (febrile neutropenia), nerve damage symptoms (neuropathy) or death caused by treatment.
What are the limitations of the evidence?
The evidence was generally of high quality and included enough data to make judgements to answer our main questions.
However, there were many types of chemotherapy used across studies. Although we have shown that platinum chemotherapy improves long‐term outcomes, we do not know what the best chemotherapy combination is.
None of the studies reported quality of life.
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