Pathological Response and Survival in Triple-Negative Breast Cancer Following Neoadjuvant Carboplatin plus Docetaxel

Abstract

Neoadjuvant carboplatin plus docetaxel yields encouraging efficacy in TNBC. Patients achieving pCR or RCB I with this regimen demonstrate excellent 3-year RFS and OS without adjuvant anthracycline.

Efficacy of deescalated chemotherapy according to PAM50 subtypes, immune and proliferation genes in triple‐negative early breast cancer: Primary translational analysis of the WSG‐ADAPT‐TN trial

“…In the WSG‐ADAPT‐TN trial evaluated here, the deescalation concept comprised short‐term (12 weeks), A‐free NACT, with favorable safety and high efficacy regarding both pCR and survival in patients with early‐response (pCR after 12 weeks of therapy) particularly if nab‐carbo therapy was used. These results are strongly in line with recently published excellent outcome after 18 weeks of docetaxel/carbo backbone without anthracycline use …”

“…These results are strongly in line with recently published excellent outcome after 18 weeks of docetaxel/carbo backbone without anthracycline use. 20 Although improved pCR under NACT suggests platinumcontaining CHT 12,23,30 as a promising treatment strategy in early TNBC, survival benefits are not yet established 17,18 ; moreover, optimal therapy combinations, 13,14,16 particularly deescalated approaches and predictive markers have yet to be determined. The present translational analysis of the WSG-ADAPT-TN trial has sought to address this need to select patients for deescalated regimens.…”

“…Such approaches may improve survival in TNBC, but evidence is not yet conclusive. Remarkably, although BRCA1 mutation—frequently associated with TNBC—is highly predictive for efficacy of carbo as a monotherapy agent, no predictive effect on survival regarding carbo addition has been demonstrated so far in the context of polychemotherapy . Relatively high chemosensitivity of BRCA1 mutation carriers to the A/T‐based CHT used as a backbone in control arms could improve their outcome sufficiently to mask a potentially predictive role of BRCA1 mutation on survival for carbo addition.…”

Activity Of Docetaxel, Carboplatin, And Doxorubicin In Patient-Derived Triple-Negative Breast Cancer Xenografts 

“…The combination of docetaxel and carboplatin was highly active in women, achieving a 55% of RCB class 0 responses (complete clearance of the tumor from breast and axilla -pCR-) and a 13% of class I responses (minimal microscopic residual disease in breast without axillary residual tumor). Both classes of pathological responses are associated with a similar, excellent, survival outcome (11,12).…”

Leptomeningeal Metastasis in a Breast Cancer Treated with Two Lines of Intrathecal Chemotherapy – a Case Report

“…There is no specific treatment of LM based on molecular subtype of BC, with the exception of trastuzumab in HER2 positive subtype. In our case, we considered thiotepa as a cell cyclenonspecific alkylat ing agent based on activity of alkylat ing agents in the triple-negative BC [8]. Niwińska et al [9] in their prospective observational study compared the efficacy of MTX and liposomal cytarabine in patients treated intrathecally.…”