Pathological Response and Survival in Triple-Negative Breast Cancer Following Neoadjuvant Carboplatin plus Docetaxel
Por:
Sharma, P, Lopez-Tarruella, S, Garcia-Saenz, JA, Khan, QJ, Gomez, HL, Prat, A, Moreno, F, Jerez-Gilarranz, Y, Barnadas, A, Picornell, AC, del Monte-Millan, M, Gonzalez-Rivera, M, Massarrah, T, Pelaez-Lorenzo, B, Palomero, MI, del Val, RG, Cortes, J, Fuentes-Rivera, H, Morales, DB, Marquez-Rodas, I, Perou, CM, Lehn, C, Wang, YY, Klemp, JR, Mammen, JV, Wagner, JL, Amin, AL, O'Dea, AP, Heldstab, J, Jensen, RA, Kimler, BF, Godwin, AK, Martin, M
Publicada:
1 dic 2018
Resumen:
Purpose: Prognostic value of pathologic complete response (pCR) and extent of pathologic response attained with anthracycline-free platinum plus taxane neoadjuvant chemotherapy (NAC) in triple-negative breast cancer (TNBC) is unknown. We report recurrence-free survival (RFS) and overall survival (OS) according to degree of pathologic response in patients treated with carboplatin plus docetaxel NAC.
Patients and Methods: One-hundred and ninety patients with stage I-III TNBC were treated with neoadjuvant carboplatin (AUC6) plus docetaxel (75 mg/m(2)) every 21 days x 6 cycles. pCR (no evidence of invasive tumor in breast and axilla) and Residual cancer burden (RCB) were evaluated. Patients were followed for recurrence and survival. Extent of pathologic response was associated with RFS and OS using the Kaplan-Meier method.
Results: Median age was 51 years, and 52% were node-positive. pCR and RCB I rates were 55% and 13%, respectively. Five percent of pCR patients, 0% of RCB I patients, and 58% of RCB II/III patients received adjuvant anthracyclines. Three-year RFS and OS were 79% and 87%, respectively. Three-year RFS was 90% in patients with pCR and 66% in those without pCR [HR = 0.30; 95% confidence interval (CI), 0.14-0.62; P = 0.0001]. Three-year OS was 94% in patients with pCR and 79% in those without pCR (HR = 0.25; 95% CI, 0.10-0.63; P = 0.001). Patients with RCB I demonstrated 3-year RFS (93%) and OS (100%) similar to those with pCR. On multivariable analysis, higher tumor stage, node positivity, and RCB II/III were associated with worse RFS.
Conclusions: 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.
Filiaciones:
Sharma, P:
Univ Kansas, Med Ctr, Div Med Oncol, Westwood, KS USA
Lopez-Tarruella, S:
Univ Complutense, Inst Invest Sanitaria Gregorio Maranon, Hosp Gen Univ Gregorio Maranon, Dept Med Oncol,CIBERONC,GEICAM, Madrid, Spain
Garcia-Saenz, JA:
Hosp Clin San Carlos, Dept Med Oncol, Madrid, Spain
Khan, QJ:
Univ Kansas, Med Ctr, Div Med Oncol, Westwood, KS USA
Gomez, HL:
Inst Nacl Enfermedades Neoplas, Dept Med Oncol, Lima, Peru
Prat, A:
Hosp Clin Barcelona, Dept Med Oncol, Barcelona, Spain
Inst Invest Biomed August Pi & Sunyer IDIBAPS, Translat Genom & Targeted Therapeut Solid Tumors, Barcelona, Spain
Moreno, F:
Hosp Clin San Carlos, Dept Med Oncol, Madrid, Spain
Jerez-Gilarranz, Y:
Univ Complutense, Inst Invest Sanitaria Gregorio Maranon, Hosp Gen Univ Gregorio Maranon, Dept Med Oncol,CIBERONC,GEICAM, Madrid, Spain
Barnadas, A:
Hosp Santa Creu & Sant Pau, Dept Med Oncol, Barcelona, Spain
Picornell, AC:
Univ Complutense, Inst Invest Sanitaria Gregorio Maranon, Hosp Gen Univ Gregorio Maranon, Dept Med Oncol,CIBERONC,GEICAM, Madrid, Spain
del Monte-Millan, M:
Univ Complutense, Inst Invest Sanitaria Gregorio Maranon, Hosp Gen Univ Gregorio Maranon, Dept Med Oncol,CIBERONC,GEICAM, Madrid, Spain
Gonzalez-Rivera, M:
Inst Invest Sanitaria Gregorio Maranon IiSGM, Lab Translat Oncol, Madrid, Spain
Massarrah, T:
Univ Complutense, Inst Invest Sanitaria Gregorio Maranon, Hosp Gen Univ Gregorio Maranon, Dept Med Oncol,CIBERONC,GEICAM, Madrid, Spain
Pelaez-Lorenzo, B:
Hosp Clin, Dept Oncol, Valladolid, Spain
Palomero, MI:
Univ Complutense, Inst Invest Sanitaria Gregorio Maranon, Hosp Gen Univ Gregorio Maranon, Dept Med Oncol,CIBERONC,GEICAM, Madrid, Spain
del Val, RG:
Univ Complutense, Inst Invest Sanitaria Gregorio Maranon, Hosp Gen Univ Gregorio Maranon, Dept Med Oncol,CIBERONC,GEICAM, Madrid, Spain
Cortes, J:
Ramon y Cajal Univ Hosp, Dept Oncol, Madrid, Spain
VHIO, Barcelona, Spain
Fuentes-Rivera, H:
Inst Nacl Enfermedades Neoplas, Dept Med Oncol, Lima, Peru
Morales, DB:
Inst Nacl Enfermedades Neoplas, Dept Med Oncol, Lima, Peru
Marquez-Rodas, I:
Univ Complutense, Inst Invest Sanitaria Gregorio Maranon, Hosp Gen Univ Gregorio Maranon, Dept Med Oncol,CIBERONC,GEICAM, Madrid, Spain
Perou, CM:
Univ N Carolina, Lineberger Comprehens Canc Ctr, Dept Genet, Chapel Hill, NC 27599 USA
Univ N Carolina, Lineberger Comprehens Canc Ctr, Dept Pathol & Lab Med, Chapel Hill, NC 27599 USA
Lehn, C:
Univ Kansas, Med Ctr, Div Med Oncol, Westwood, KS USA
Wang, YY:
Univ Kansas, Med Ctr, Div Med Oncol, Westwood, KS USA
Klemp, JR:
Univ Kansas, Med Ctr, Div Med Oncol, Westwood, KS USA
Mammen, JV:
Univ Kansas, Med Ctr, Div Med Oncol, Westwood, KS USA
Wagner, JL:
Univ Kansas, Med Ctr, Div Med Oncol, Westwood, KS USA
Amin, AL:
Univ Kansas, Med Ctr, Div Med Oncol, Westwood, KS USA
O'Dea, AP:
Univ Kansas, Med Ctr, Div Med Oncol, Westwood, KS USA
Heldstab, J:
Univ Kansas, Med Ctr, Div Med Oncol, Westwood, KS USA
Jensen, RA:
Univ Kansas, Med Ctr, Div Med Oncol, Westwood, KS USA
Kimler, BF:
Univ Kansas, Med Ctr, Div Med Oncol, Westwood, KS USA
Godwin, AK:
Univ Kansas, Med Ctr, Div Med Oncol, Westwood, KS USA
Martin, M:
Univ Complutense, Inst Invest Sanitaria Gregorio Maranon, Hosp Gen Univ Gregorio Maranon, Dept Med Oncol,CIBERONC,GEICAM, Madrid, Spain
Green Accepted, Bronze
|