Efficacy and safety of carboplatin-containing chemotherapy in triple-negative breast cancer: A comprehensive systematic review, meta-analysis, and trial sequential analysis with BRCA/HRD subgroup assessment.

Authors

Muhammad Maaz Amjad, Muaz Shehzar Bashir, Khwaja Waleed Maqbool, Tayyaba Ikram Qazi, Minahil Ali, Muhammad Ahmad Idrees, Ahmad Ali, Sania Wazir, Hassam Safdar Khan, Sami Ullah, Umber Khan, Zamurd Khan, Amir Hamza Khan, Rudaina Hanif, Muhammad Huzaifa Khattak, Asia Batool, Sajjad Ghanim Al-Badri, Zayna Rehman, Aleena Amir Malik, Bilal Wazir Khan

Published in

Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners. Pages 10781552261478559. Aug 17, 2026. Epub Aug 17, 2026.

Abstract

BackgroundTriple-negative breast cancer (TNBC) is an aggressive subtype with limited targeted treatment options. Platinum agents, particularly carboplatin's DNA damaging properties suggest efficacy, its impact on survival outcomes and toxicity remains uncertain.MethodsPubMed, Embase, Scopus, Cochrane Library, and ClinicalTrials.gov were searched from inception to February 2026. Phase II/III RCTs comparing carboplatin plus standard chemotherapy with standard therapy alone in TNBC were included. Primary outcomes were disease-free survival (DFS), overall survival (OS), and pathological complete response (pCR). Pooled hazard ratios (HRs) and risk ratios (RRs) were calculated using random-effects models.ResultsTwenty-three trials (n = 8797) were included. Carboplatin significantly improved DFS (HR 0.68, 95% CI 0.60-0.76), OS (HR 0.65, 95% CI 0.53-0.80), and pCR (RR 1.46, 95% CI 1.30-1.64). Improvements were also observed in distant disease-free survival and recurrence-free survival. However, carboplatin was associated with increased hematological toxicities, including anemia, neutropenia, and thrombocytopenia, and higher rates of dose reduction and treatment discontinuation, though treatment-related mortality was not significant.ConclusionCarboplatin-containing chemotherapy improves survival outcomes and pCR in TNBC. Despite increased toxicity, adverse effects are generally manageable. These findings support the incorporation of carboplatin into TNBC treatment, with careful patient selection to balance efficacy and safety.

PMID:
42606368
Bibliographic data and abstract were imported from PubMed on 17 Aug 2026.

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