Efficacy of Neoadjuvant Carboplatin plus Docetaxel in Triple-Negative Breast Cancer: Combined Analysis of Two Cohorts
Por:
Sharma, P, Lopez-Tarruella, S, Garcia-Saenz, JA, Ward, C, Connor, CS, 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, Rivera, HF, Morales, DB, Marquez-Rodas, I, Perou, CM, Wagner, JL, Mammen, JMV, McGinness, MK, Klemp, JR, Amin, AL, Fabian, CJ, Heldstab, J, Godwin, AK, Jensen, RA, Kimler, BF, Khan, QJ, Martin, M
Publicada:
1 feb 2017
Resumen:
Purpose: Recent studies demonstrate that addition of neoadjuvant (NA) carboplatin to anthracycline/taxane chemotherapy improves pathologic complete response (pCR) in triple-negative breast cancer (TNBC). Effectiveness of anthracycline-free platinum combinations in TNBC is not well known. Here, we report efficacy of NA carboplatin+docetaxel (CbD) in TNBC.
Experimental Design: The study population includes 190 patients with stage I-III TNBC treated uniformly on two independent prospective cohorts. All patients were prescribed NA chemotherapy regimen of carboplatin (AUC 6)+docetaxel (75 mg/m2) given every 21 days x 6 cycles. pCR (no evidence of invasive tumor in the breast and axilla) and residual cancer burden (RCB) were evaluated.
Results: Among 190 patients, median tumor size was 35 mm, 52% were lymph node positive, and 16% had germline BRCA1/2 mutation. The overall pCR and RCB 0+1 rates were 55% and 68%, respectively. pCRs in patients with BRCA-associated and wild-type TNBC were 59% and 56%, respectively (P = 0.83). On multivariable analysis, stage III disease was the only factor associated with a lower likelihood of achieving a pCR. Twenty-one percent and 7% of patients, respectively, experienced at least one grade 3 or 4 adverse event.
Conclusions: The CbD regimen was well tolerated and yielded high pCR rates in both BRCA-associated and wild-type TNBC. These results are comparable with pCR achieved with the addition of carboplatin to anthracycline-taxane chemotherapy. Our study adds to the existing data on the efficacy of platinum agents in TNBC and supports further exploration of the CbD regimen in randomized studies. (C) 2016 AACR.
Filiaciones:
Sharma, P:
Univ Kansas, Med Ctr, 2330 Shawnee Mission Pkwy,Mailstop 5003, Westwood, KS 66205 USA
Lopez-Tarruella, S:
Hosp Gen Univ Gregorio Maranon, Med Oncol Serv, IiSGM, Madrid, Spain
Garcia-Saenz, JA:
Hosp Clin San Carlos, Med Oncol Dept, Madrid, Spain
Ward, C:
Univ Kansas, Med Ctr, 2330 Shawnee Mission Pkwy,Mailstop 5003, Westwood, KS 66205 USA
Connor, CS:
Univ Kansas, Med Ctr, 2330 Shawnee Mission Pkwy,Mailstop 5003, Westwood, KS 66205 USA
Gomez, HL:
Inst Nacl Enfermedades Neoplas, Med Oncol Dept, Lima, Peru
Prat, A:
Hosp Clin Barcelona, Dept Med Oncol, Barcelona, Spain
Vall dHebron Inst Oncol VHIO, Translat Genom Grp, Barcelona, Spain
August Pi & Sunyer Biomed Res Inst IDIBAPS, Translat Genom & Targeted Therapeut Solid Tumors, Barcelona, Spain
Moreno, F:
Hosp Clin San Carlos, Med Oncol Dept, Madrid, Spain
Jerez-Gilarranz, Y:
Hosp Gen Univ Gregorio Maranon, Med Oncol Serv, IiSGM, Madrid, Spain
Barnadas, A:
Hosp Santa Creu & Sant Pau, Dept Med Oncol, Barcelona, Spain
Picornell, AC:
IISGM, Madrid, Spain
del Monte-Millan, M:
Hosp Gen Univ Gregorio Maranon, Med Oncol Serv, IiSGM, Madrid, Spain
Gonzalez-Rivera, M:
IiSGM, Lab Translat Oncol, Madrid, Spain
Massarrah, T:
Hosp Gen Univ Gregorio Maranon, Med Oncol Serv, IiSGM, Madrid, Spain
Pelaez-Lorenzo, B:
Hosp Clin, Dept Oncol, Valladolid, Spain
Palomero, MI:
Hosp Gen Univ Gregorio Maranon, Med Oncol Serv, IiSGM, Madrid, Spain
del Val, RG:
Hosp Gen Univ Gregorio Maranon, Med Oncol Serv, IiSGM, Madrid, Spain
Cortes, J:
Ramon & Cajal Univ Hosp, Dept Oncol, Madrid, Spain
Vall dHebron Inst Oncol VHIO, Barcelona, Spain
Rivera, HF:
Inst Nacl Enfermedades Neoplas, Med Oncol Dept, Lima, Peru
Morales, DB:
Inst Nacl Enfermedades Neoplas, Med Oncol Dept, Lima, Peru
Marquez-Rodas, I:
Hosp Gen Univ Gregorio Maranon, Med Oncol Serv, IiSGM, Madrid, Spain
Perou, CM:
Univ North Carolina Chapel Hill, Lineberger Comprehens Canc Ctr, Dept Genet, Chapel Hill, NC USA
Univ North Carolina Chapel Hill, Dept Pathol & Lab Med, Chapel Hill, NC USA
Wagner, JL:
Univ Kansas, Med Ctr, 2330 Shawnee Mission Pkwy,Mailstop 5003, Westwood, KS 66205 USA
Mammen, JMV:
Univ Kansas, Med Ctr, 2330 Shawnee Mission Pkwy,Mailstop 5003, Westwood, KS 66205 USA
McGinness, MK:
Univ Kansas, Med Ctr, 2330 Shawnee Mission Pkwy,Mailstop 5003, Westwood, KS 66205 USA
Klemp, JR:
Univ Kansas, Med Ctr, 2330 Shawnee Mission Pkwy,Mailstop 5003, Westwood, KS 66205 USA
Amin, AL:
Univ Kansas, Med Ctr, 2330 Shawnee Mission Pkwy,Mailstop 5003, Westwood, KS 66205 USA
Fabian, CJ:
Univ Kansas, Med Ctr, 2330 Shawnee Mission Pkwy,Mailstop 5003, Westwood, KS 66205 USA
Heldstab, J:
Univ Kansas, Med Ctr, 2330 Shawnee Mission Pkwy,Mailstop 5003, Westwood, KS 66205 USA
Godwin, AK:
Univ Kansas, Med Ctr, 2330 Shawnee Mission Pkwy,Mailstop 5003, Westwood, KS 66205 USA
Jensen, RA:
Univ Kansas, Med Ctr, 2330 Shawnee Mission Pkwy,Mailstop 5003, Westwood, KS 66205 USA
Kimler, BF:
Univ Kansas, Med Ctr, 2330 Shawnee Mission Pkwy,Mailstop 5003, Westwood, KS 66205 USA
Khan, QJ:
Univ Kansas, Med Ctr, 2330 Shawnee Mission Pkwy,Mailstop 5003, Westwood, KS 66205 USA
Martin, M:
Hosp Gen Univ Gregorio Maranon, Med Oncol Serv, IiSGM, Madrid, Spain
Green Accepted, Bronze
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