Platinum-based chemotherapy in metastatic triple negative breast cancer: Experience of a tertiary referral centre in India.

Experimental data suggest that triple-negative breast cancer (TNBC) may have increased sensitivity to platinum-based chemotherapy but there is lack of relevant clinical data. Clinical outcomes in patients with metastatic TNBC treated with Platinum-based chemotherapy were evaluated in this prospective study.

METHODS

21 selected patients with metastatic TNBC presenting at GCRI during the study period from 1st August 2009 to 31st October 2011 formed the study group with median follow up period of 10 months. They were given palliative chemotherapy based upon prior adjuvant chemotherapy along with an additional platinum compound. Response rates, response duration and toxicities of platinum-based chemotherapy were recorded and analyzed.

RESULTS

In evaluable TNBC patients, overall response rate and complete clinical response were 72% and 38% with median response duration of four months. Response could not be assessed in three patients due to patient refusal for evaluation, lost to follow up and toxicities. In three TNBC patients after completion of platinum based chemotherapy have early isolated CNS relapse with systemic disease in remission. Haematological adverse effects were febrile neutropenia in 19% of patients, and grade 3–4 neutropenia (9%) thrombocytopenia and anaemia (7%). The main non-hematological adverse effects reported in the present study were peripheral neuropathy (14%) and severe emesis (9%). The most common Platinum-based chemotherapy combination was carboplatin and paclitaxel in 11 patients (52%) of evaluable patients. Patients who received this regime have complete response rate, overall response rate and toxicity was 45%, 65% and 10%.

CONCLUSIONS

TNBC patients with platinum-based chemotherapy have better overall response rates, higher complete clinical response rates, prolonged response duration and acceptable safety profile. The results of the present study need to be confirmed with a larger randomized study with a longer follow up.