Platinum-containing regimens for triple-negative metastatic breast cancer.


BACKGROUND:In a previous Cochrane Review, we found that for women with metastatic breast cancer unselected for triple-negative disease, there is little or no survival benefit and excess toxicity from platinum-based regimens. In subgroup analyses, however, we found preliminary low-quality evidence of a survival benefit from platinum-based regimens for women with metastatic triple-negative breast cancer (mTNBC). This review updates the evidence from the mTNBC subgroup analyses in the previous Cochrane Review. OBJECTIVES:To assess the effects of platinum-containing chemotherapy regimens with regimens not containing platinum in the management of women with mTNBC. SEARCH METHODS:We obtained relevant studies published prior to 2015 and their extracted results from the mTNBC subgroup analysis in the previous Cochrane Review. We searched the Cochrane Breast Cancer Group's Specialised Register, CENTRAL, MEDLINE, Embase, the World Health Organization's International Clinical Trials Registry Platform and between 2015 and 27 September 2019. We identified further potentially relevant studies from previous trial reports, systematic reviews, and meta-analyses. SELECTION CRITERIA:Randomised trials comparing platinum-containing chemotherapy regimens with regimens not containing platinum in women with mTNBC. Individual trials could compare one or more platinum-based regimens to one or more non-platinum regimens; hence there could be more 'treatment-comparisons' (i.e. platinum regimen versus non-platinum regimen comparison) than trials. Trial participants may have been purposely selected for mTNBC or inadvertently selected as a subgroup. DATA COLLECTION AND ANALYSIS:At least two independent reviewers assessed studies for eligibility and quality, and extracted all relevant data from each study. We derived hazard ratios (HRs) for time-to-event outcomes, where possible, and used fixed-effect models for meta-analyses. We analysed objective tumour response rates (OTRRs) and toxicities as binary (dichotomous) outcomes with risk ratios (RRs) used as measures of effects. We extracted quality of life data, if available. We used GRADE to rate the quality of evidence for time-to-event and tumour response outcomes. MAIN RESULTS:This review includes 13 treatment-comparisons involving 1349 women from 10 studies. Twelve of the 13 treatment-comparisons were included in one or more meta-analyses. Of the 13 treatment-comparisons, six and eight had published or provided time-to-event data on overall survival (OS) or progression-free survival/time to progression (PFS/TTP), respectively, that could be included in meta-analyses. Ten treatment-comparisons published or provided OTRR data that could be included in meta-analyses. Eight of the 13 treatment-comparisons were from studies that selected participants on the basis of mTNBC status, while the other five treatment-comparisons were from studies that reported mTNBC results as part of subgroup analyses. Analysis of six treatment-comparisons indicated that platinum-containing regimens may have provided a small survival benefit to mTNBC patients (HR 0.85, 95% CI 0.73 to 1.00; 958 women; moderate-quality evidence) with no evidence of heterogeneity (P = 0.41; I2 = 1%). Data from eight treatment-comparisons showed that platinum regimens may improve PFS/TTP (HR 0.77, 95% CI 0.68 to 0.88; 1077 women; very low-quality evidence). There was marked evidence of heterogeneity (P < 0.0001; I2 = 80%). There was also low-quality evidence of better tumour response for platinum recipients (RR 1.40, 95% CI 1.22 to 1.59; 1205 women) with some evidence of heterogeneity (P = 0.01; I2 = 58%). The observed heterogeneity for the PFS/TTP and OTRR outcomes may reflect between-study differences and general difficulties in assessing tumour response, as well as the varying potencies of the comparators. Compared with women receiving non-platinum regimens: rates of grade 3 and 4 nausea/vomiting were higher for platinum recipients (RR 4.77, 95% CI 1.93 to 11.81; 655 women; low-quality evidence) and rates of grade 3 and 4 anaemia were higher for platinum recipients (RR 3.80, 95% CI 2.25 to 6.42; 843 women; low-quality evidence). In general, however, relatively few intervention-comparisons could be included in meta-analyses for adverse events. None of the studies reported quality of life. AUTHORS' CONCLUSIONS:For women with mTNBC, there was moderate-quality evidence of a small survival benefit from platinum-based regimens compared to non-platinum regimens. This finding is consistent with findings of a PFS/TTP benefit and improved tumour response from platinum-based regimens. These potential benefits, however, should be weighed against previously identified excess toxicities from platinum-based regimens, particularly regimens containing cisplatin. Further randomised trials of platinum-based regimens among women with mTNBC are required.


Egger SJ,Chan MMK,Luo Q,Wilcken N




Has Abstract


2020-10-21 00:00:00








  • Primaquine alternative dosing schedules for preventing malaria relapse in people with Plasmodium vivax.

    abstract:BACKGROUND:Plasmodium vivax liver stages (hypnozoites) may cause relapses, prolonging morbidity, and impeding malaria control and elimination. The World Health Organization (WHO) recommends three schedules for primaquine: 0.25 mg/kg/day (standard), or 0.5 mg/kg/day (high standard) for 14 days, or 0.75 mg/kg once weekly...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章


    authors: Milligan R,Daher A,Villanueva G,Bergman H,Graves PM

    更新日期:2020-08-19 00:00:00

  • Face-to-face interventions for informing or educating parents about early childhood vaccination.

    abstract:BACKGROUND:Early childhood vaccination is an essential global public health practice that saves two to three million lives each year, but many children do not receive all the recommended vaccines. To achieve and maintain appropriate coverage rates, vaccination programmes rely on people having sufficient awareness and a...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Kaufman J,Ryan R,Walsh L,Horey D,Leask J,Robinson P,Hill S

    更新日期:2018-05-08 00:00:00

  • Antidepressants using active placebos.

    abstract:BACKGROUND:Although there is a consensus that antidepressants are effective in depression, placebo effects are also thought to be substantial. Side effects of antidepressants may reveal the identity of medication to participants or investigators and thus may bias the results of conventional trials using inert placebos....

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Moncrieff J,Wessely S,Hardy R

    更新日期:2001-01-01 00:00:00

  • Teaching critical appraisal skills in healthcare settings.

    abstract:BACKGROUND:Critical appraisal is the process of assessing and interpreting evidence by systematically considering its validity, results and relevance to an individual's work. Within the last decade critical appraisal has been added as a topic to many medical school and UK Royal College curricula, and several continuing...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Horsley T,Hyde C,Santesso N,Parkes J,Milne R,Stewart R

    更新日期:2011-11-09 00:00:00

  • Immunotherapy for IgM anti-Myelin-Associated Glycoprotein paraprotein-associated peripheral neuropathies.

    abstract:BACKGROUND:Serum monoclonal anti-Myelin Associated Glycoprotein antibodies may be pathogenic in some patients with IgM paraprotein and demyelinating neuropathy. Immunotherapies aimed at reducing the level of these antibodies might be expected to be of benefit in the treatment of the neuropathy. Many potential therapies...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Lunn MP,Nobile-Orazio E

    更新日期:2003-01-01 00:00:00

  • Methadone for cancer pain.

    abstract:BACKGROUND:Methadone is an opioid used in the management of cancer pain both in opioid naïve patients and in rotation from other opioids. A particular role in neuropathic pain has been suggested. The quest for evidence based palliative care prompted a formal appraisal of methadone in comparison with other analgesics. ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Nicholson AB

    更新日期:2004-01-01 00:00:00

  • Combined spinal-epidural versus spinal anaesthesia for caesarean section.

    abstract:BACKGROUND:Single-shot spinal anaesthesia (SSS) and combined spinal-epidural (CSE) anaesthesia are both commonly used for caesarean section anaesthesia. Spinals offer technical simplicity and rapid onset of nerve blockade which can be associated with hypotension. CSE anaesthesia allows for more gradual onset and also p...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Simmons SW,Dennis AT,Cyna AM,Richardson MG,Bright MR

    更新日期:2019-10-11 00:00:00

  • Dietary fibre for the prevention of recurrent colorectal adenomas and carcinomas.

    abstract:BACKGROUND:This is an update of the Cochrane review published in 2002.Colorectal cancer (CRC) is a major cause of morbidity and mortality in industrialised countries. Experimental evidence has supported the hypothesis that dietary fibre may protect against the development of CRC, although epidemiologic data have been i...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Yao Y,Suo T,Andersson R,Cao Y,Wang C,Lu J,Chui E

    更新日期:2017-01-08 00:00:00

  • Interventions for the prevention of nutritional rickets in term born children.

    abstract:BACKGROUND:Nutritional rickets is a disease of growing children leading to bone deformities, bone pain, convulsions or delayed motor development. Today, high-incidence of nutritional rickets is mainly found in low-income countries. OBJECTIVES:To assess the effects of various interventions on the prevention of nutritio...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Lerch C,Meissner T

    更新日期:2007-10-17 00:00:00

  • Topical rubefacients for acute and chronic pain in adults.

    abstract:BACKGROUND:Rubefacients (containing salicylates or nicotinamides) cause irritation of the skin, and are believed to relieve various musculoskeletal pains. They are available on prescription, and are common components in over-the-counter remedies. A non-Cochrane review in 2004 found limited evidence for efficacy. OBJEC...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Matthews P,Derry S,Moore RA,McQuay HJ

    更新日期:2009-07-08 00:00:00

  • Interventions for chronic abacterial prostatitis.

    abstract:BACKGROUND:Chronic abacterial prostatitis is a common disabling but enigmatic condition with a symptom complex of pelvic area pain and lower urinary tract symptoms. The scope of treatments recommended for chronic abacterial prostatitis is a testament to how little is known about what causes the condition and how to tre...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: McNaughton C,Mac Donald R,Wilt T

    更新日期:2001-01-01 00:00:00

  • Tocolytics for preterm premature rupture of membranes.

    abstract:BACKGROUND:In women with preterm labor, tocolysis has not been shown to improve perinatal mortality; however, it is often given for 48 hours to allow for the corticosteroid effect for fetal maturation. In women with preterm premature rupture of membranes (PPROM), the use of tocolysis is still controversial. In theory, ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Mackeen AD,Seibel-Seamon J,Grimes-Dennis J,Baxter JK,Berghella V

    更新日期:2011-10-05 00:00:00

  • Psychological interventions for needle-related procedural pain and distress in children and adolescents.

    abstract:BACKGROUND:This is the second update of a Cochrane Review (Issue 4, 2006). Pain and distress from needle-related procedures are common during childhood and can be reduced through use of psychological interventions (cognitive or behavioral strategies, or both). Our first review update (Issue 10, 2013) showed efficacy of...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析


    authors: Birnie KA,Noel M,Chambers CT,Uman LS,Parker JA

    更新日期:2018-10-04 00:00:00

  • Sports and games for post-traumatic stress disorder (PTSD).

    abstract:BACKGROUND:Traumatic experiences evoke emotions such as fear, anxiety and distress and may encourage avoidance of similar situations in the future. For a proportion of those exposed to a traumatic event, this emotional reaction becomes uncontrollable and can develop into Post Traumatic Stress Disorder (PTSD) (Breslau 2...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Lawrence S,De Silva M,Henley R

    更新日期:2010-01-20 00:00:00

  • Quetiapine for schizophrenia.

    abstract:BACKGROUND:Quetiapine is a novel atypical antipsychotic with low propensity for movement disorder adverse effects. It is used for treatment of schizophrenia and other psychoses. OBJECTIVES:To determine the effects of quetiapine for schizophrenia in comparison to placebo, classical and other atypical antipsychotics. S...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Srisurapanont M,Disayavanish C,Taimkaew K

    更新日期:2000-01-01 00:00:00

  • Strategies for improving the acceptability and acceptance of the copper intrauterine device.

    abstract:BACKGROUND:Intrauterine devices (IUDs) are highly effective and are the most widely used reversible contraceptive method in the world. However, in developed countries IUDs are among the least common methods of contraception used. We evaluated the effect of interventions to increase uptake of the copper IUD, a long-acti...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Arrowsmith ME,Aicken CR,Saxena S,Majeed A

    更新日期:2012-03-14 00:00:00

  • Corticosteroids for cervical ripening and induction of labour.

    abstract:BACKGROUND:The role of corticosteroids in the process of labour is not well understood. Animal studies have shown the importance of cortisol secretion by the fetal adrenal gland in initiating labour in sheep. Infusion of glucocorticosteroids into the fetus has also shown to induce premature labour in sheep. Given these...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Kavanagh J,Kelly AJ,Thomas J

    更新日期:2006-04-19 00:00:00

  • Interventions for treating headlice.

    abstract:BACKGROUND:Infection with head lice is a widespread condition in developed and developing countries. Infection occurs most commonly in children, but also affects adults. If left untreated the condition can become intensely irritating and skin infections may occur if the bites are scratched. OBJECTIVES:The aim of this ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Dodd CS

    更新日期:2001-01-01 00:00:00

  • School policies for preventing smoking among young people.

    abstract:BACKGROUND:School tobacco policies (STPs) might prove to be a promising strategy to prevent smoking initiation among adolescents, as there is evidence that the school environment can influence young people to smoke. STPs are cheap, relatively easy to implement and have a wide reach, but it is not clear whether this app...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Coppo A,Galanti MR,Giordano L,Buscemi D,Bremberg S,Faggiano F

    更新日期:2014-10-24 00:00:00

  • Depot fluphenazine for schizophrenia.

    abstract:BACKGROUND:In the years after the discovery of oral antipsychotic medications, it became clear that there was a link between stopping medication and relapse of psychotic symptoms. A series of long-acting preparations was developed. These depot preparations, are frequently used for those who find taking oral medication ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Adams CE,Eisenbruch M

    更新日期:2000-01-01 00:00:00

  • Open retropubic colposuspension for urinary incontinence in women.

    abstract:BACKGROUND:Urinary incontinence is a common and potentially debilitating problem. Open retropubic colposuspension is a surgical treatment which involves lifting the tissues near the bladder neck and proximal urethra in the area behind the anterior pubic bones to correct deficient urethral closure to correct stress urin...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Lapitan MC,Cody JD

    更新日期:2016-02-15 00:00:00

  • Non-pharmacological interventions for epilepsy in people with intellectual disabilities.

    abstract:BACKGROUND:Approximately 30% of epilepsy patients remain refractory to drug treatment and continue to experience seizures whilst taking one or more antiepileptic drugs. There are a number of non-pharmacological interventions available to refractory patients which may be used in conjunction with or as an alternative to ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Beavis J,Kerr M,Marson AG

    更新日期:2007-10-17 00:00:00

  • Mobile bearing vs fixed bearing prostheses for total knee arthroplasty for post-operative functional status in patients with osteoarthritis and rheumatoid arthritis.

    abstract:BACKGROUND:The polyethylene insert in a total knee replacement (TKR) can be fixed to the tibial plateau or it can have freedom of rotation and / or translation. It is not yet clear whether there are differences in functional or clinical results between the two prosthesis types. OBJECTIVES:The goal of this review is to...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Jacobs W,Anderson P,Limbeek J,Wymenga A

    更新日期:2004-01-01 00:00:00

  • Laser treatment of drusen to prevent progression to advanced age-related macular degeneration.

    abstract:BACKGROUND:Drusen are amorphous yellowish deposits beneath the sensory retina. People with drusen, particularly large drusen, are at higher risk of developing age-related macular degeneration (AMD). The most common complication in AMD is choroidal neovascularisation (CNV), the growth of new blood vessels in the centre ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Virgili G,Michelessi M,Parodi MB,Bacherini D,Evans JR

    更新日期:2015-10-23 00:00:00

  • Positive airway pressure therapy for the treatment of central sleep apnoea associated with heart failure.

    abstract:BACKGROUND:Ischaemic heart disease including heart failure is the most common cause of death in the world, and the incidence of the condition is rapidly increasing. Heart failure is characterised by symptoms such as fatigue and breathlessness during light activity, as well as disordered breathing during sleep. In parti...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析


    authors: Yamamoto S,Yamaga T,Nishie K,Nagata C,Mori R

    更新日期:2019-12-04 00:00:00

  • Vaccines for preventing pneumococcal infection in adults.

    abstract:BACKGROUND:Diseases caused by Streptococcus pneumoniae (S. pneumoniae) continue to cause substantial morbidity and mortality globally. Whilst pneumococcal polysaccharide vaccines (PPVs) have the potential to prevent disease and death, the degree of protection afforded against various clinical endpoints and within diffe...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Moberley S,Holden J,Tatham DP,Andrews RM

    更新日期:2013-01-31 00:00:00

  • Interventions for treating scabies.

    abstract:BACKGROUND:Scabies is an intensely itchy parasitic infection of the skin caused by the Sarcoptes scabiei mite. It is a common public health problem with an estimated global prevalence of 300 million cases. Serious adverse effects have been reported for some drugs used to treat scabies. OBJECTIVES:To evaluate topical a...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Strong M,Johnstone P

    更新日期:2007-07-18 00:00:00

  • Long-acting inhaled bronchodilators for cystic fibrosis.

    abstract:BACKGROUND:Cystic fibrosis is a life-limiting inherited condition which affects one in 2500 newborns in the UK and 70,000 children and adults worldwide. The condition is multifaceted and affects many systems in the body. The respiratory system is particularly affected due to a build up of thickened secretions and a pre...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Smith S,Edwards CT

    更新日期:2017-12-19 00:00:00

  • Hypertonic saline versus other intracranial pressure-lowering agents for people with acute traumatic brain injury.

    abstract:BACKGROUND:Increased intracranial pressure has been shown to be strongly associated with poor neurological outcomes and mortality for patients with acute traumatic brain injury. Currently, most efforts to treat these injuries focus on controlling the intracranial pressure. Hypertonic saline is a hyperosmolar therapy th...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析


    authors: Chen H,Song Z,Dennis JA

    更新日期:2020-01-17 00:00:00

  • Auditory integration training and other sound therapies for autism spectrum disorders (ASD).

    abstract:BACKGROUND:Auditory integration therapy was developed as a technique for improving abnormal sound sensitivity in individuals with behavioural disorders including autism spectrum disorders. Other sound therapies bearing similarities to auditory integration therapy include the Tomatis Method and Samonas Sound Therapy. O...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审


    authors: Sinha Y,Silove N,Hayen A,Williams K

    更新日期:2011-12-07 00:00:00