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. 2018 Dec 1;24(23):5820-5829.
doi: 10.1158/1078-0432.CCR-18-0585. Epub 2018 Jul 30.

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

Priyanka Sharma  1 , Sara López-Tarruella  2 , José Angel García-Saenz  3 , Qamar J Khan  4 , Henry L Gómez  5 , Aleix Prat  6   7 , Fernando Moreno  3 , Yolanda Jerez-Gilarranz  2 , Agustí Barnadas  8 , Antoni C Picornell  2 , María Del Monte-Millán  2 , Milagros González-Rivera  9 , Tatiana Massarrah  2 , Beatriz Pelaez-Lorenzo  10 , María Isabel Palomero  2 , Ricardo González Del Val  2 , Javier Cortés  11 , Hugo Fuentes-Rivera  5 , Denisse Bretel Morales  5 , Iván Márquez-Rodas  2 , Charles M Perou  12 , Carolyn Lehn  4 , Yen Y Wang  4 , Jennifer R Klemp  4 , Joshua V Mammen  4 , Jamie L Wagner  4 , Amanda L Amin  4 , Anne P O'Dea  4 , Jaimie Heldstab  4 , Roy A Jensen  4 , Bruce F Kimler  4 , Andrew K Godwin  4 , Miguel Martín  13
Affiliations

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

Priyanka Sharma et al. Clin Cancer Res. .

Abstract

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 = 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.

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Conflict of interest statement

Conflict of interest statement: The authors have declared no conflicts of interest.

Figures

Figure 1:
Figure 1:
CONSORT diagram a In addition to the various centers in Spain, the Spanish cohort includes a center from Lima, Peru.
Figure 2:
Figure 2:
(A) Recurrence-free survival by pCR status; (B) Overall survival by pCR status; (C) Recurrence-free survival by RCB 0/I vs RCB II/III; (D) Overall survival by RCB 0/I vs RCB II/III. a RCB unavailable for 3 patients
Figure 3:
Figure 3:
(A) Recurrence-free survival by RCB class; (B) Overall survival by RCB class. a RCB unavailable for 3 patients
See this image and copyright information in PMC

References

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