Expert review of anticancer therapy · 2026
Neoadjuvant treatment regimens associated with pathological complete response in triple-negative breast cancer: a systematic review and network meta-analysis.
СтатьяСистематический обзорNetwork Meta-AnalysisСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Menegat Brenda Luana Rocha Soares, Menegat Ana Luíza Rocha Soares, Ferreira Piccoli Maria Victória, Diniz Guerra Braz Luana, Rebelo Thiago Gorayeb, de Moraes Francisco Cezar Aquino
Аннотация
INTRODUCTION: Triple-negative breast cancer (TNBC) lacks estrogen, progesterone, and HER2 receptors, limiting treatment options. Neoadjuvant anthracycline- and taxane-based chemotherapy remains standard, achieving pathological complete response (pCR) rates of approximately 30%. We compared neoadjuvant treatments for early-stage TNBC using a systematic review and network meta-analysis (NMA).
METHODS: PubMed, EMBASE, and Cochrane were searched for randomized and observational studies of neoadjuvant treatment in TNBC. Odds ratios (OR) with 95% confidence intervals were pooled using a random-effects model. Certainty of evidence was assessed with GRADE. Statistical analyses were performed using RStudio.
RESULTS: Thirty-seven studies with 7683 patients were included. Twenty-five treatment nodes were formed, with paclitaxel (P) or docetaxel (D) + anthracycline-based (A) chemotherapy as the main comparator. Compared with PA-based + cyclophosphamide, higher pCR rates were observed with PA-based + carboplatin + pembrolizumab + cyclophosphamide (OR 3.04) and PA-based + carboplatin + veliparib + cyclophosphamide (OR 2.67). When DA-based + cyclophosphamide was the comparator, DA-based + cyclophosphamide + bevacizumab (OR 1.67) increased pCR. The SUCRA ranked PA-based + carboplatin + pembrolizumab, paclitaxel + carboplatin + atezolizumab, and DA-based + lobaplatin as most effective.
CONCLUSIONS: Platinum agents, PARP inhibitors, and immune checkpoint inhibitors were associated with higher pCR rates in early-stage TNBC.
PROTOCOL REGISTRATION: CRD42025640277.
METHODS: PubMed, EMBASE, and Cochrane were searched for randomized and observational studies of neoadjuvant treatment in TNBC. Odds ratios (OR) with 95% confidence intervals were pooled using a random-effects model. Certainty of evidence was assessed with GRADE. Statistical analyses were performed using RStudio.
RESULTS: Thirty-seven studies with 7683 patients were included. Twenty-five treatment nodes were formed, with paclitaxel (P) or docetaxel (D) + anthracycline-based (A) chemotherapy as the main comparator. Compared with PA-based + cyclophosphamide, higher pCR rates were observed with PA-based + carboplatin + pembrolizumab + cyclophosphamide (OR 3.04) and PA-based + carboplatin + veliparib + cyclophosphamide (OR 2.67). When DA-based + cyclophosphamide was the comparator, DA-based + cyclophosphamide + bevacizumab (OR 1.67) increased pCR. The SUCRA ranked PA-based + carboplatin + pembrolizumab, paclitaxel + carboplatin + atezolizumab, and DA-based + lobaplatin as most effective.
CONCLUSIONS: Platinum agents, PARP inhibitors, and immune checkpoint inhibitors were associated with higher pCR rates in early-stage TNBC.
PROTOCOL REGISTRATION: CRD42025640277.