Platinum-based neoadjuvant chemotherapy (NACT) in triple-negative breast cancer (TNBC): A systematic review and meta-analysis of randomized controlled trials (RCTs).

595Background: The role of platinum-based NACT in TNBC is highly controversial and its use is not endorsed by current guidelines in unselected TNBC patients. Our meta-analysis aimed to better evaluate the activity, efficacy and safety of platinum-based NACT in TNBC. Methods: A systematic search of MEDLINE, Web of Knowledge and conference proceedings up to October 31th 2017 was performed to identify RCTs evaluating platinum-based vs. platinum-free NACT in TNBC patients. Summary risk estimates (odds ratio [OR] and hazard ratio [HR] with 95% confidence intervals [CI]) were calculated for the effect of platinum-based vs. platinum-free NACT in terms of pathological complete response (pCR: ypT0/is pN0), event-free survival (EFS), overall survival (OS), and grade 3-4 adverse events (AEs: neutropenia, anemia, thrombocytopenia and neuropathy). Pooled analyses were performed using the fixed- and random-effect models. This study is registered in the PROSPERO website (CRD42018080042). Results: Nine RCTs (n = 2,107 pa...