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Breast Cancer Research and Treatment

, Volume 160, Issue 3, pp 425–437 | Cite as

Platinum salts in advanced breast cancer: a systematic review and meta-analysis of randomized clinical trials

  • Fausto Petrelli
  • Sandro Barni
  • Giacomo Bregni
  • Filippo de Braud
  • Serena Di Cosimo
Review

Abstract

Background

The interest in platinum salts in breast cancer (BC) therapy has been recently renewed as inhibition of DNA damage response may enhance the effects of DNA-damaging agents in BC tumors with high genomic instability. The present systematic review and meta-analysis of randomized trials were performed to assess the efficacy and safety of therapy with platinum salts in patients with locally advanced or metastatic (hereinafter advanced) BC.

Methods

We searched PubMed, EMBASE, SCOPUS, Web of Science, the Cochrane Library, and CINAHL for phase II/III clinical trials that assessed efficacy of platinum-based therapy in patients with advanced BC. Pooled estimates of overall response rate (RR), median progression-free survival (PFS) and overall survival (OS) were computed using random or fixed effects models.

Results

Data on 4625 patients from 23 phase II and III trials (11 with cisplatin, 11 with carboplatin, and 1 with either agents respectively) were analyzed. Estimates for RR, PFS, and OS were obtained from 23, 13, and 15 studies, respectively. Although at the cost of significantly increased fatigue, hematological and gastrointestinal toxicity, compared with non-platinum schemas, cisplatin, and carboplatin prolonged OS (HR 0.91; 95 % CI 0.83–1.00, p = 0.04), PFS (HR 0.84; 95 % CI 0.73–0.97, p = 0.01), and RR (HR 1.27; 95 % CI 1.03–1.57, p = 0.03).

Conclusions

Despite some limitations of the studies examined, including partial information on hormonal receptor and HER2 status, the use of platinum salts significantly prolonged OS, and PFS of patients with advanced BC with no unexpected toxicity.

Keywords

Advanced breast cancer Cisplatinum Carboplatinum Meta-analysis Survival 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interest.

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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Fausto Petrelli
    • 1
  • Sandro Barni
    • 1
  • Giacomo Bregni
    • 2
  • Filippo de Braud
    • 3
  • Serena Di Cosimo
    • 4
  1. 1.Medical Oncology UnitASST Bergamo OvestTreviglioItaly
  2. 2.Department of Medical OncologyIRCCS A.O.U. S.Martino-ISTGenoaItaly
  3. 3.University of Milan, Fondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
  4. 4.Division of OncologyFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly

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