Platinum‐based chemotherapy in advanced triple‐negative breast cancer: A multicenter real‐world study in China

Abstract Platinum‐based chemotherapy (PBC) has proven benefits in phase III studies for advanced triple‐negative breast cancer (TNBC) patients; however, real‐world data of large samples from multiple centers are lacking. Our study was to compare the effectiveness of PBC and non‐PBC in advanced TNBC patients in multicenter real‐world settings. Totally, 495 patients with advanced TNBC receiving PBC (n = 350) or non‐PBC (n = 145) at four cancer centers in China between 2003 and 2019 were included. Treatment responses and outcomes were compared between the two groups from first‐line to third‐line treatment. Of patients with PBC, 249 (71.1%) received PBC from first‐line chemotherapy, 86 (24.6%) from second‐line and 15 (4.3%) from third‐line treatment. In first‐line treatment, PBC was superior to non‐PBC in objective response rate (ORR, 53.0% vs 32.1%, P < .001) and median progression‐free survival (PFS, 8.4 vs 6.0 months, P = .022), whereas overall survival (OS) was similar (19.2 vs 16.8 months, P = .439). When comparing patients receiving non‐PBC doublets (n = 221) with those receiving PBC doublets (n = 249), the same trend was observed in ORR (32.6% vs 53.0%, P < .001), median first‐line PFS (6.5 vs 8.4 months, P = .041) and median first‐line OS(17.8 vs 19.2 months, P = .568). Paclitaxel/docetaxel + platinum was more likely to be used, followed by gemcitabine + platinum. In second/third‐line treatment, PBC yielded a similar response and survival compared to non‐PBC. Adding PBC in the first‐line therapy was better than that in the latter‐line of treatment in terms of ORR, PFS and OS ( P < .001). Toxic effects of PBC were tolerable and the most common adverse event was neutropenia (38.6%). PBC doublets exhibited superior efficacy and manageable toxicity compared to non‐PBC doublets in the first‐line treatment for Chinese mTNBC patients.