Efficacy of neoadjuvant carboplatin plus docetaxel in triple-negative breast cancer: Combined analysis of two cohorts

Priyanka Sharma, Sara López-Tarruella, Jose Angel García-Saenz, Claire Ward, Carol S. Connor, Henry L. Gómez, Aleix Prat, Fernando Moreno, Yolanda Jerez-Gilarranz, Augusti Barnadas, Antoni C. Picornell, Maria Del Monte-Millán, Milagros Gonzalez-Rivera, Tatiana Massarrah, Beatriz Pelaez-Lorenzo, María Isabel Palomero, Ricardo González Del Val, Javier Cortes, Hugo Fuentes Rivera, Denisse Bretel MoralesIván Márquez-Rodas, Charles M. Perou, Jamie L. Wagner, Joshua M.V. Mammen, Marilee K. McGinness, Jennifer R. Klemp, Amanda L. Amin, Carol J. Fabian, Jaimie Heldstab, Andrew K. Godwin, Roy A. Jensen, Bruce F. Kimler, Qamar J. Khan, Miguel Martin

Research output: Contribution to journalArticlepeer-review

109 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)649-657
Number of pages9
JournalClinical Cancer Research
Volume23
Issue number3
DOIs
StatePublished - Feb 1 2017
Externally publishedYes

ASJC Scopus subject areas

  • General Medicine

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