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Cancer Treatment and Pharmacology / Breast Cancer Treatment Studies · Review
Journal of Oncology Pharmacy Practice · August 17, 2026
Well-designed and adequately powered for the question it asks.
This meta-analysis of 23 Phase II/III RCTs comprising 8797 TNBC patients demonstrates that carboplatin-containing chemotherapy significantly improves disease-free survival, overall survival, and pathological complete response compared to standard chemotherapy alone. While hematological toxicities are increased, treatment-related mortality is not significantly elevated, supporting clinical incorporation with appropriate patient selection.
Meta-analysis of Phase II/III randomized controlled trials. Patients with triple-negative breast cancer enrolled in Phase II/III randomized controlled trials evaluating carboplatin-containing chemotherapy.. Intervention: Carboplatin plus standard chemotherapy. Compared with: Standard chemotherapy alone. n = 8,797.
Disease-free survival improved with carboplatin: HR 0.68 (95% CI 0.60–0.76) Overall survival improved with carboplatin: HR 0.65 (95% CI 0.53–0.80) Pathological complete response increased with carboplatin: RR 1.46 (95% CI 1.30–1.64)
Carboplatin associated with increased hematological toxicities (anemia, neutropenia, thrombocytopenia) and higher rates of dose reduction and treatment discontinuation Treatment-related mortality was not significant with carboplatin-containing therapy
These findings provide strong support for incorporating carboplatin into first-line TNBC treatment regimens, with meaningful improvements in both survival and response rates. Clinicians should use these data to counsel patients on the survival benefit while implementing supportive care strategies for hematological toxicities and monitoring for dose adjustments.
High-quality meta-analysis of 23 Phase II/III RCTs (n=8797) demonstrating clinically meaningful improvements in DFS, OS, and pCR with carboplatin-containing chemotherapy in TNBC, with rigorous pooling and quantified safety trade-offs.
As stated by the source record.
Quoted from the source exactly as published.
These findings provide strong support for incorporating carboplatin into first-line TNBC treatment regimens, with meaningful improvements in both survival and response rates. Clinicians should use these data to counsel patients on the survival benefit while implementing supportive care strategies for hematological toxicities and monitoring for dose adjustments.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
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.
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