by Xiaomeng Jia, Kainan Wang, Lingzhi Xu, Ning Li, Zuowei
Zhao, Man Li
The Breast: September 02, 2022
Introduction
Platinum-based chemotherapy (PBC) remains the mainstay of
treatments for triple-negative breast cancer (TNBC). TNBC is a heterogeneous
group, the issue of whether BRCA1/2 mutation carriers have a
particular sensitivity to platinum agents is inconclusive. We conducted a
meta-analysis to explore the relationship between BRCA1/2 mutation
and PBC susceptibility in individuals with TNBC, aiming to gain more
information on the size of the benefit of PBC in BRCA1/2 mutation
carriers.
Materials and methods
All studies applying PBC with a subgroup of BRCA1/2 status
were included. All endpoints, including pCR and RCB in the neoadjuvant phase,
DFS in the adjuvant phase, ORR, PFS, and OS in the advanced phase, were
assessed using HRs and 95% Cl.
Results
From the 22 studies included, there were 2158 patients with
TNBC, with 392 (18%) bearing the BRCA1/2 gene mutation. Based on 13
studies applying neoadjuvant PBC, we discovered that BRCA1/2 mutation
was substantially associated with a 17.6% increased pCR rate (HR 1.32, 95% CI
1.17–1.49, p < 0.00001; I2 = 51%). Same result was
observed in RCB0/I index (HR 1.38, 95% CI 1.08–1.76, P = 0.009; I2 = 0%).
The meta-analysis of 6 trials addressing advanced therapy revealed that ORR
rates were significantly higher in patients with BRCA1/2 mutation (HR
1.91, 95% CI 1.48–2.47, p < 0.00001; I2 = 32%), as well
as PFS(HR 1.13, 95% CI 0.81–1.57, P = 0.47; I2 = 0%) and OS
(HR 1.89, 95% CI 1.22–2.92, P = 0.004; I2 = 0%).
Conclusion
According to our meta-analysis of 22 trials in TNBC, BRCA1/2 mutation
carriers were significantly more sensitive to PBC regimens, especially in
neoadjuvant and advanced therapy.
