Background: Triple-negative breast cancer(TNBC) is highly aggressive with mortality rates higher than hormone-positive because of the shortage of applied therapy. The main approach for TNBC patients was the neoadjuvant chemotherapy (NACT) to achieve pathological complete response (pCR). The ultimate goal of pCR is to improve local outcomes, event-free and overall survival (OS). adding platinum-based agents to NACT showing promising activity in achieving pCR in TNBC.
Study objective: To stand out the role of adding platinum-based agents to NACT in enhancing pCR rates in TNBC patients. Also, to evaluate the safety of platinum-based agents concerning complications.
Materials and Method: Retrospective study comprised medical records from 80 TNBC patients divided into 2 groups (40/group) treated with NACT either platinum free or platinum-based protocol from 2017 to 2022 at oncology department of both Ain shams and Alexandria university hospitals.
Results: Median age was 48.5. 50% were postmenopausal. 55% of the patients were T3, T4. 45% had positive LNS. pCR rates were favourable in platinum-based group, 17 patients (42.5%) achieved pCR, 23 patients (57.5%) had residuals while in platinum-free group, 9 patients (22.5%) achieved pCR, 31 patients (77.5%) had residuals with significant difference assessment by Pearson's Chi-square Test=3.647, P=0.047.
Platinum based group had higher incidence of grade 3,4 complications than platinum free group shown with odds ratio 2.17 in thrombocytopenia, 3 in nausea and vomiting, lastly 5.57 in nephropathy.
Conclusion: In TNBC patients, adding platinums to NACT is associated with higher pCR rates with mild complications so it may be considered an optional treatment.