O papel das platinas no tumor de mama triplo negativo

Abstract

Triple-negative breast cancer is an aggressive subtype characterized by low HER2 expression, with a higher risk of recurrence and a worse prognosis. This study aims to analyze the role of platinum compounds in the treatment of triple-negative breast cancer (TNBC), highlighting their clinical outcomes, impacts on progression-free survival, and toxicity. This is a systematic literature review, without meta-analysis, using PubMed, searching articles published between 2013 and 2025. A total of 19 studies of platinum compounds in the treatment of TNBC were included, 13 of which were randomized clinical trials. In neoadjuvant therapy, the addition of carboplatin increased pCR from 36.9% to 53.2% and event-free survival (EFS) at 4 years (HR 0.57, 95% CI 0.36–0.91; p = 0.02), while pembrolizumab increased pCR to 64.8% and survival to 86.6% at 5 years (p = 0.002). In adjuvant therapy, regimens containing carboplatin showed that disease-free survival (DFS) was up to 93.9% at 3 years, with less toxicity. After neoadjuvant therapy, platinum was inferior to capecitabine, with progression-free survival (PFS of 42% vs 49% at 3 years). In the metastatic setting, the use of platinum increased objective response (81.1% vs. 56.3%) and PFS (9.8 vs. 7.4 months). Experimental studies indicate that new platinum compounds and combined strategies, such as TTFields or melatonin, are more selective and consistent against TNBC. It is concluded that carboplatin improves response and survival in TNBC, being less toxic in adjuvant settings. Capecitabine is superior in residual disease, and platinum has good results in metastatic cancer.