TY - JOUR
T1 - Pathological Response and Survival in Triple-Negative Breast Cancer Following Neoadjuvant Carboplatin plus Docetaxel
AU - Sharma, Priyanka
AU - Lopez-Tarruella, Sara
AU - García-Saenz, Jose Angel
AU - Khan, Qamar J.
AU - Gomez, Henry L.
AU - Prat, Aleix
AU - Moreno, Fernando
AU - Jerez-Gilarranz, Yolanda
AU - Barnadas, Agustí
AU - Picornell, Antoni C.
AU - del Monte-Millan, María
AU - Gonzalez-Rivera, Milagros
AU - Massarrah, Tatiana
AU - Pelaez-Lorenzo, Beatriz
AU - Palomero, María Isabel
AU - del Val, Ricardo Gonzalez
AU - Cortes, Javier
AU - Fuentes-Rivera, Hugo
AU - Morales, Denisse Bretel
AU - Marquez-Rodas, Ivan
AU - Perou, Charles M.
AU - Lehn, Carolyn
AU - Wang, Yen Y.
AU - Klemp, Jennifer R.
AU - Mammen, Joshua V.
AU - Wagner, Jamie L.
AU - Amin, Amanda L.
AU - O'Dea, Anne P.
AU - Heldstab, Jaimie
AU - Jensen, Roy A.
AU - Kimler, Bruce F.
AU - Godwin, Andrew K.
AU - Martín, Miguel
N1 - Publisher Copyright:
©2018 American Association for Cancer Research.
PY - 2018/12/1
Y1 - 2018/12/1
N2 - 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/m2) every 21 days 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 ¼ 0.30; 95% confidence interval (CI), 0.14–0.62; P ¼ 0.0001]. Three-year OS was 94% in patients with pCR and 79% in those without pCR (HR ¼ 0.25; 95% CI, 0.10–0.63; P ¼ 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.
AB - 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/m2) every 21 days 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 ¼ 0.30; 95% confidence interval (CI), 0.14–0.62; P ¼ 0.0001]. Three-year OS was 94% in patients with pCR and 79% in those without pCR (HR ¼ 0.25; 95% CI, 0.10–0.63; P ¼ 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.
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U2 - 10.1158/1078-0432.CCR-18-0585
DO - 10.1158/1078-0432.CCR-18-0585
M3 - Article
C2 - 30061361
AN - SCOPUS:85057781678
SN - 1078-0432
VL - 24
SP - 5820
EP - 5829
JO - Clinical Cancer Research
JF - Clinical Cancer Research
IS - 23
ER -