BMJ：复旦大学邵志敏团队证实，加入卡铂，显著改善高危早期三阴性乳腺癌生存期

Core Viewpoint - The study published in the British Medical Journal demonstrates that adding carboplatin to standard chemotherapy significantly improves survival outcomes for high-risk early-stage triple-negative breast cancer (TNBC) patients, increasing the three-year disease-free survival rate from 85.8% to 92.3% [2][3]. Study Design: Focus on High-Risk Patients - The CITRINE trial included 808 high-risk early-stage TNBC patients who underwent definitive surgical treatment, defined as high-risk due to either positive regional lymph nodes or negative lymph nodes with a Ki-67 proliferation index of ≥50% [5]. Treatment Protocol - Patients were randomly assigned to two groups: - Carboplatin group (experimental): Received four cycles of epirubicin and cyclophosphamide followed by four cycles of paclitaxel combined with carboplatin [6][7]. - Standard treatment group (control): Received four cycles of epirubicin and cyclophosphamide followed by four cycles of paclitaxel alone [9][10]. Significant Efficacy: Reduced Recurrence Risk - After a median follow-up of 44.7 months, the carboplatin group achieved a three-year disease-free survival rate of 92.3%, compared to 85.8% in the control group, indicating a 36% reduction in the risk of recurrence or death (hazard ratio of 0.64) [12][11]. Safety Profile: Manageable Risks - The incidence of grade 3-4 treatment-related adverse events was 66.7% in the carboplatin group, slightly higher than the 55.0% in the control group, primarily involving hematological toxicities. No new safety issues were identified, and there were no treatment-related deaths [15][16]. Three-Year Survival Rates - Three-year recurrence-free survival: Carboplatin group 93.8% vs. control group 88.3% - Three-year distant disease-free survival: Carboplatin group 94.8% vs. control group 89.8% - Three-year overall survival: Carboplatin group 98.0% vs. control group 94.0% [17]. Study Significance - This research fills the evidence gap regarding carboplatin in adjuvant therapy, providing a clear treatment option for high-risk TNBC patients who undergo direct surgery without neoadjuvant therapy. Over half of clinical stage II-III TNBC patients receive direct surgery, highlighting the need for effective adjuvant therapies [18]. Future Outlook: Personalized Treatment Directions - The study offers hope for high-risk early-stage TNBC patients, showing that adding carboplatin to standard chemotherapy can significantly lower recurrence risk and improve survival rates. This "Chinese solution" not only marks a milestone in breast cancer research in China but also provides new options for global TNBC treatment [20]. Future research will focus on more precise treatments through the discovery and validation of additional biomarkers, as well as the combination of carboplatin with other targeted therapies or immunotherapies [21].