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

Lobefaro, Riccardo; Mariani, Luigi; Peverelli, Giorgia; Ligorio, Francesca; Fucà, Giovanni; Rametta, Alessandro; Zattarin, Emma; Leporati, Rita; Presti, Daniele; Cantarelli, Beatrice; Depretto, Cathérine; Vingiani, Andrea; Manoukian, Siranoush; Scaperrotta, Gianfranco; Bianchi, Giulia; Capri, Giuseppe; Pruneri, Giancarlo; Braud, Filippo de; Vernieri, Claudio

doi:10.1016/j.clbc.2022.12.008

Cited by 4 publications

(3 citation statements)

References 41 publications

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“…We recently published the results of a retrospective study, which showed that, among aTNBC patients pretreated with taxanes in the context of (neo)adjuvant chemotherapy, those receiving first‐line CBDCA‐gemcitabine have better PFS and OS when compared to patients receiving first‐line CBDCA‐paclitaxel 20 . In the present study, all patients (100%) undergoing cyclic FMD in combination with platinum‐based chemotherapy received CBDCA‐gemcitabine as chemotherapy backbone, while only 25% of patients in the control cohort received this chemotherapy regimen.…”

Section: Resultsmentioning

confidence: 99%

Adding fasting‐mimicking diet to first‐line carboplatin‐based chemotherapy is associated with better overall survival in advanced triple‐negative breast cancer patients: A subanalysis of the NCT03340935 trial

Ligorio,

Lobefaro,

Fucà

et al. 2023

Intl Journal of Cancer

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Severe calorie restriction, in the form of cyclic fasting or fasting‐mimicking diets (FMDs), boosts the antitumor activity of cytotoxic chemotherapy in mouse models of triple‐negative breast cancer (TNBC). This effect is mostly mediated by fasting/FMD‐induced reduction of plasma glucose concentration and by a boost in antitumor immunity. However, clinical evidence that cyclic FMD may impact on the outcomes of advanced TNBC (aTNBC) patients is lacking. We compared the overall survival (OS) of 14 aTNBC patients receiving first‐line carboplatin‐gemcitabine plus cyclic FMD in the context of the NCT03340935 trial with the OS of 76 consecutive aTNBC patients treated with carboplatin‐based chemotherapy alone at Fondazione IRCCS Istituto Nazionale dei Tumori. Multivariable Cox regression models were used to adjust the prognostic impact of FMD for other prognostic variables. Patients undergoing cyclic FMD in combination with carboplatin‐gemcitabine had better OS when compared to patients receiving chemotherapy alone (median OS 30.3 months, 95% CI 18‐NR, vs 17.2 months, 95% CI 15.3‐25.1, log‐rank P value .041). Multivariable analysis confirmed an association between FMD use and better OS (HR: 0.40; 95% CI: 0.19‐0.86; P = .019) also after propensity score‐based matching according to patient ECOG PS and the presence of de novo metastatic disease (HR: 0.41; 95% CI: 0.21‐0.83; P = .013). Cyclic FMD in combination with first‐line chemotherapy may improve clinical outcomes in aTNBC patients. Our study paves the way for conducting phase II trials to investigate if cyclic FMD can increase the antitumor activity/efficacy of chemotherapy or chemoimmunotherapy in patients with early‐stage TNBC or aTNBC.

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Section: Resultsmentioning

confidence: 99%

Adding fasting‐mimicking diet to first‐line carboplatin‐based chemotherapy is associated with better overall survival in advanced triple‐negative breast cancer patients: A subanalysis of the NCT03340935 trial

Ligorio,

Lobefaro,

Fucà

et al. 2023

Intl Journal of Cancer

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“…2 By contrast, in patients with PD-L1positive aTNBC, which represent about 30-40% of all aTNBC cases, the combination of taxaneor carboplatin-gemcitabine chemotherapy with anti-programmed cell death protein 1/PD-L1 immune checkpoint inhibitors proved to be superior to chemotherapy alone, and it is now considered the first-line standard treatment for most of these patients. [3][4][5] Several cytotoxic agents are effective against aTNBC (both PD-L1 positive and PD-L1 negative), with different activity and safety profiles. Carboplatin, alone or in combination with paclitaxel or gemcitabine, is one of the most effective cytotoxic agents in aTNBC patients; 6,7 however, with the exception of germline pathogenic BRCA1/BRCA2 mutations, no other biomarkers associated with benefit (or lack of benefit) from carboplatin chemotherapy (as compared to other cytotoxic agents) have emerged so far.…”

Section: Introductionmentioning

confidence: 99%

“…2 By contrast, in patients with PD-L1-positive aTNBC, which represent about 30–40% of all aTNBC cases, the combination of taxane- or carboplatin–gemcitabine chemotherapy with anti-programmed cell death protein 1/PD-L1 immune checkpoint inhibitors proved to be superior to chemotherapy alone, and it is now considered the first-line standard treatment for most of these patients. 3–5…”

Section: Introductionmentioning

confidence: 99%

The pan-immune-inflammation value is associated with clinical outcomes in patients with advanced TNBC treated with first-line, platinum-based chemotherapy: an institutional retrospective analysis

et al. 2023

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Background: Advanced triple-negative breast cancer (aTNBC) has a poor prognosis; thus, there is a need to identify novel biomarkers to guide future research and improve clinical outcomes. Objectives: We tested the prognostic ability of an emerging, complete blood count (CBC)-based inflammatory biomarker, the pan-immune-inflammation value (PIV), in patients with aTNBC treated with first-line, platinum-based chemotherapy. Design: This was a retrospective, monocentric, observational study. Methods: We included consecutive aTNBC patients treated with platinum-based, first-line chemotherapy at our Institution, and for whom baseline (C1) CBC data were available. We collected CBC data early on-treatment, when available. PIV was calculated as: (neutrophil count × platelet count × monocyte count)/lymphocyte count. Patients with hormone receptor-positive (HR+), human epidermal growth factor receptor 2 (HER2)-negative advanced breast cancer (aBC) were included in a control, non-TNBC cohort. Results: A total of 78 aTNBC patients were included. When evaluated as a continuous variable, PIV-C1 was associated with worse overall survival (OS; p < 0.001) and progression-free survival (PFS; p < 0.001). On the other hand, when PIV-C1 was assessed on the basis of its quantile distribution, patients with ‘high PIV-C1’ experienced worse OS [adjusted hazard ratio (HR): 4.46, 95% confidence interval (CI): 2.22–8.99; adjusted p < 0.001] and PFS (adjusted HR: 2.03, 95% CI: 1.08–3.80; adjusted p = 0.027) when compared to patients with ‘low PIV-C1’. Higher PIV-C1 was also associated with primary resistance to chemotherapy. Similarly, a higher PIV calculated from CBC at C2D1 (PIV-C2) was associated with worse survival outcomes. We also created a PIV-based score combining information about both PIV-C1 and PIV-C2 and allowing the stratification of patients at low, intermediate, and high risk of death. No association was observed between PIV-C1 and clinical outcomes of HR+/HER2− aBC patients. Conclusion: PIV has a promising prognostic discrimination ability in aTNBC patients treated with first-line, platinum-based chemotherapy. Both baseline and early on-treatment PIV are associated with clinical outcomes and may be exploited for creating PIV-based risk classifiers if further validated.

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Is Taxane Rechallenge Time Dependent in Patients With Advanced Triple-Negative Breast Cancer?

Altundağ

2023

Clinical Breast Cancer

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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

Cited by 4 publications

References 41 publications

Adding fasting‐mimicking diet to first‐line carboplatin‐based chemotherapy is associated with better overall survival in advanced triple‐negative breast cancer patients: A subanalysis of the NCT03340935 trial

Adding fasting‐mimicking diet to first‐line carboplatin‐based chemotherapy is associated with better overall survival in advanced triple‐negative breast cancer patients: A subanalysis of the NCT03340935 trial

The pan-immune-inflammation value is associated with clinical outcomes in patients with advanced TNBC treated with first-line, platinum-based chemotherapy: an institutional retrospective analysis

Is Taxane Rechallenge Time Dependent in Patients With Advanced Triple-Negative Breast Cancer?

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