Original Study| Volume 23, ISSUE 3, e151-e162, April 2023

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Efficacy and Safety of First-line Carboplatin-paclitaxel and Carboplatin-gemcitabine in Patients With Advanced Triple-negative Breast Cancer: A Monocentric, Retrospective Comparison

Published:December 16, 2022DOI:



      Platinum-based chemotherapy is widely used in patients with advanced triple-negative breast cancer (TNBC). However, the most effective platinum-based combination in the first-line treatment setting remains unclear.

      Materials and Methods

      We evaluated the efficacy of first-line carboplatin-paclitaxel (CP) or carboplatin-gemcitabine (CG) combinations in advanced TNBC patients treated between April 2007 and April 2021. CP and CG were compared in terms of progression-free survival (PFS), overall survival (OS), and incidence of adverse events (AEs). Multivariable Cox Models were used to adjust the efficacy of CP versus CG for clinically relevant covariates.


      Of 88 consecutive advanced TNBC patients receiving first-line carboplatin-based doublets, 56 (63.6%) received CP and 32 (36.4%) CG. After adjusting for clinically relevant variables, patients receiving CG had significantly better PFS when compared to CP-treated patients (HR: 0.49 (95% CI, 0.27-0.87), P value 0.014). Of note, CG was associated with better PFS only among patients previously treated with taxanes in the (neo)adjuvant setting (HR: 0.39; 95% CI, 0.21-0.75), but not in patients not exposed to taxanes (HR: 1.20; 95% CI, 0.37-3.88). CG was also independently associated with better OS when compared to CP (HR: 0.31 (95% CI: 0.15-0.64), P value 0.002). Overall, grade 3-4 AEs were more common in patients treated with CG than in patients treated with CP (68.8% vs. 21.4%, P value .009).


      CG and CP are effective and well tolerated first-line platinum doublets in advanced TNBC patients. CG could be more effective than CP in patients previous exposed to taxanes despite worse toxicity profile.



      AEs (Adverse Events), AUC (Area Under the Curve), BC (Breast Cancer), BMI (Body Mass Index), CG (Carboplatin plus Gemcitabine), CI (Confidence Interval), CP (Carboplatin plus Paclitaxel), CR (Complete Response), DCR (Disease Control Rate), DFI (Disease-Free Interval), DOR (Duration Of Response), ECOG (Eastern Cooperative Oncology Group), ER (Estrogen Receptor), HER2 (Human Epidermal Growth Factor Receptor 2), HR (Hazard Ratio), i.v. (Intravenous), IHC (ImmunoHistoChemistry), ISH (In Situ Hybridization), ORR (Overall Response Rate), OS (Overall Survival), PARPi (Polyadenosine Diphosphate-Ribose Polymerase Inhibitors), PD-L1 (Programmed Death-Ligand 1), PFS (Progression Free Survival), PgR (Progesterone Receptor), PR (Partial Response), PS (Performance Status), SD (Stable Disease), TNBC (Triple Negative Breast Cancer)
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