A randomized phase 3 trial of Gemcitabine or Nab-paclitaxel combined with cisPlatin as first-line treatment in patients with metastatic triple-negative breast cancer

作者：Wang, Biyun^*; Sun, Tao; Zhao, Yannan; Wang, Shusen; Zhang, Jian; Wang, Zhonghua; Teng, Yue-E; Cai, Li; Yan, Min; Wang, Xiaojia; Jiang, Zefei; Pan, Yueyin; Luo, Jianfeng; Shao, Zhimin; Wu, Jiong; Guo, Xiaomao; Hu, Xichun^*

来源：Nature Communications, 2022, 13(1): 4025.

DOI：10.1038/s41467-022-31704-7

• GERMLINE MUTATIONS
• PLUS GEMCITABINE
• DOUBLE-BLIND
• CHEMOTHERAPY
• CARBOPLATIN
• MULTICENTER
• BEVACIZUMAB
• DOXORUBICIN
• PATTERNS
• FEATURES

Platinum is recommended in combination with gemcitabine in the treatment of metastatic triple-negative breast cancer (mTNBC). We conduct a randomized phase 3, controlled, openlabel trial to compare nab-paclitaxel/cisplatin (AP) with gemcitabine/cisplatin (GP) in mTNBC patients (ClinicalTrials.gov NCT02546934). 254 patients with untreated mTNBC randomly receive AP (nab-paclitaxel 125 mg/m(2) on day 1, 8 and cisplatin 75 mg/m(2) on day 1) or GP (gemcitabine 1250 mg/m(2) on day 1, 8 and cisplatin 75 mg/m(2) on day 1) intravenously every 3 weeks until progression disease, intolerable toxicity or withdrawal of consent. The primary endpoint is progression-free survival (PFS); secondary endpoints are objective response rate (ORR), safety and overall survival (OS). The trial has met pre-specified endpoints. The median PFS is 9.8 months with AP as compared to 7.4 months with GP (stratified HR, 0.67; 95% CI, 0.50-0.88; P = 0.004). AP significantly increases ORR (81.1% vs. 56.3%, P < 0.001) and prolongs OS (stratified HR, 0.62; 95% CI, 0.44-0.90; P = 0.010) to GP. Of grade 3 or 4 adverse events, a significantly higher incidence of neuropathy in AP and thrombocytopenia in GP is noted. These findings warrant further assessment of adding novel agents to the nab-paclitaxel/platinum backbone due to its high potency for patients with mTNBC.

• 单位
  安徽医科大学; 中山大学; 1; 中国医科大学; 哈尔滨医科大学; 郑州大学; 复旦大学; 5