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British Journal of Medical and Health Research

British Journal of Medical and Health Research

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Platinum Plus Immunotherapy Versus Platinum Alone in Triple-Negative Breast Cancer: A Systematic Review

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Published in September 2026 Issue 09 (Vol. 13, Issue 9, 2026)

Platinum Plus Immunotherapy Versus Platinum Alone in Triple-Negative Breast Cancer: A Systematic Review - Issue cover

Keywords

Platinum Plus ImmunotherapyTriple-negative breast cancerestrogen receptor

Abstract

Triple-negative breast cancer (TNBC) represents approximately 15–20% of all breast cancers and is characterized by the absence of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) expression. TNBC is associated with aggressive clinical behavior , higher rates of visceral metastasis, earlier recurrence, and poorer overall prognosis compared to other breast cancer subtypes. Cytotoxic chemotherapy has historically remained the mainstay of systemic treatment. Among available agents, platinum compounds such as carboplatin and cisplatin have demonstrated particular activity because TNBC frequently exhibits defects in homologous recombination DNA repair pathways, including BRCA1/2 dysfunction. In recent years, immune checkpoint inhibitors against programmed death-1 (PD-1) or programmed death-ligand 1 (PD-L1) have emerged as promising therapeutic strategies. Combining immunotherapy with platinum-based chemotherapy may enhance antitumor immunity and improve outcomes. Objective To conduct a systematic review of existing evidence that contrasts the use of platinum combined with immunotherapy against platinum alone in individuals with early-stage and metastatic TNBC, with an emphasis on evaluating efficacy, survival rates, pathological complete response, and safety. Results Significant trials such as KEYNOTE-355, KEYNOTE-522, IMpassion130, IMpassion031, GeparNuevo, NeoTRIPaPDL1, along with various pooled analyses, have shown enhanced pathological complete response (pCR), progression-free survival (PFS), event-free survival (EFS), and overall survival (OS) in specific TNBC groups receiving platinum combined with immunotherapy, as opposed to chemotherapy alone. The advantages were particularly evident in PD-L1-positive metastatic TNBC and early-stage II–III TNBC. Nonetheless, the incidence of immune-related adverse events was higher in the arms receiving combination therapy. Conclusion Conclusion present data indicate that combining platinum with immunotherapy offers a more effective treatment approach than using platinum by itself for carefully chosen patients with TNBC. It remains crucial to select patients based on biomarkers and to manage toxicity effectively.

References

  1. [1]This was the first positive immunotherapy trial for breast cancer. Most validated biomarker for metastatic TNBC. However, immunotherapy combinations are increasingly becoming the standard of care where available. De-escalation strategies for responders Novel immune combinations (TIGIT, LAG-3, vaccines) PD-L1 positive metastatic disease The combination improved pCR, PFS, EFS, and OS but increased immune-related adverse events. Future treatment selection should integrate biomarkers, patient comorbidities, and access considerations. Poggio F, et al. Platinum-based neoadjuvant chemotherapy meta-analysis in TNBC. Ann Oncol. 2018. Sikov WM, et al. CALGB 40603 trial. J Clin Oncol. 2015. Loibl S, et al. BrighTNess trial. Lancet Oncol. 2018. Cortes J, Cescon DW, Rugo HS, et al. Pembrolizumab plus chemotherapy in advanced TNBC. Lancet. 2022. Schmid P, et al. KEYNOTE-355 trial. N Engl J Med. 2020. Schmid P, Adams S, Rugo HS, et al. Atezolizumab in metastatic TNBC. N Engl J Med. 2018. Schmid P, Cortes J, Pusztai L, et al. KEYNOTE-522. N Engl J Med. 2020. Mittendorf EA, et al. IMpassion031 trial. Lancet. 2020. Loibl S, et al. GeparNuevo trial. Ann Oncol. 2019. Gianni L, et al. NeoTRIPaPDL1. Ann Oncol. 2021. Emens LA, et al. Biomarkers for immunotherapy in breast cancer. Nat Rev Clin Oncol. 2021. Loi S, et al. TILs and TNBC outcomes. Ann Oncol. 2019. Wang C, et al. Immunotherapy plus chemotherapy meta-analysis in TNBC. Front Oncol. 2024. Zhang J, et al. Checkpoint inhibitors systematic review. Breast Cancer Res Treat. 2023. Santa-Maria CA, et al. Immunotherapy in TNBC. Cancers (Basel). 2021. Adams S, et al. Pembrolizumab monotherapy TNBC. J Clin Oncol. 2019. Nanda R, et al. KEYNOTE-086. J Clin Oncol. 2019. Litton JK, et al. BRCA and platinum sensitivity. J Clin Oncol. 2018. Tutt A, et al. OlympiA trial. N Engl J Med. 2021. Sharma P, et al. Cisplatin response in TNBC. Clin Cancer Res. 2017. Dirix LY, et al. Avelumab in metastatic breast cancer. JAMA Oncol. 2018. Cortazar P, et al. pCR as surrogate endpoint. Lancet. 2014. Rugo HS, et al. TNBC treatment advances. JAMA Oncol. 2023. Tolaney SM, et al. Clinical update TNBC. J Clin Oncol. 2024. Denkert C, et al. Neoadjuvant immunotherapy review. Nat Rev Clin Oncol. 2022. NCCN Guidelines Breast Cancer. 2025. ESMO Breast Cancer Guidelines. 2024. Miles D, et al. IMpassion131. Ann Oncol. 2021. Bardia A, et al. Metastatic TNBC review. Cancer Treat Rev. 2023. Dent R, et al. Triple-negative breast cancer clinical review. Lancet Oncol. 2021.

Authors (4)

Animesh Kumar Mishra

Deputy Medical Superintendent

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Parmita Roy

Clinical Pharmacologist & Medi...

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Silky Kumari

Clinical Pharmacologist

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Shubhartha Kayal

Senior Clinical Pharmacist

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Article Information

Published in:

September 2026 Issue 09 (Vol. 13, Issue 9, 2026)

BJMHR9130003

BJMHR-13-000065

30-38

2026-09-11

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How to Cite

Kumar, A., & Roy & Kumari & Kayal (2026). Platinum Plus Immunotherapy Versus Platinum Alone in Triple-Negative Breast Cancer: A Systematic Review. British Journal of Medical and Health Research, 13(9), 30-38. https://bjmhr.com/articles/BJMHR9130003

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