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Efficacy of neoadjuvant carboplatin/docetaxel chemotherapy in sporadic and BRCA-associated triple-negative breast cancer (TNBC).
Abstracts that were granted an exception in accordance with ASCO's Conflict of Interest Policy are designated with a caret symbol (^).
Background: Recent studies demonstrate that addition of carboplatin to anthracycline/taxane chemotherapy improves pathological complete response (pCR) in TNBC. In vitro data exhibits synergy between platinum compunds and taxanes in TNBC. Efficacy of anthracycline-devoid neoadjuvant platinum/taxane combination in sporadic and BRCA-associated TNBC is not well known. Aim: To evaluate the efficacy of neoadjuvant Carboplatin/Docetaxel in sporadic and BRCA-associated TNBC utilizing clinical and BRCA mutation data from a prospective registry. Methods: 205 patients with stage I (T>1cm) II or III TNBC were enrolled in a prospective multisite registry between 2011-2013, out of which 42 patients received neoadjuvant chemotherapy regimen of Carboplatin AUC 6 + Docetaxel 75 mg/m2every 21 D (4-6 cycles). Following neoadjuvant therapy, all patients underwent breast surgery. pCR (no evidence of invasive tumor in the breast and axilla) and Residual Cancer Burden(RCB) was evaluated. RCB of 0 or1 was designated as near pCR (pCRn). All patients underwent comprehensive BRACAnalysis (Myriad). Results: For the 42 eligible patients, median age was 51 years (range 27-80), 19%: African-American and 57%: postmenopausal. Median tumor size was 3 cm and 33% LN positive. 90% of patients received 6 and 10% received 4 cycles of chemotherapy. The overall pCR and pCRn rates were 62% and 74%, respectively. 33% (14/42) of patients carried deleterious BRCA mutation (11 BRCA1, 3 BRCA2). For BRCAmutation carriers, both pCR and pCRn rates were 86%(12/14). For sporadic TNBC (N=28), pCR and pCRn rates were 50% and 68%, respectively. Tumor size, LN status, age and number of cycles of chemotherapy did not impact pCR rate. pCR was higher in BRCA mutation carriers compared to sporadic TNBC (p=0.04). Conclusions: We report very encouraging near pathologic response in both sporadic (68%) and BRCA-associated (86%)TNBC with a neoadjuvant platinum/taxane chemotherapy regimen. This Carboplatin/Docetaxel combination yielded pCR rates similar to observed rates with A/C plus Carboplatin however, is devoid of potential cardiac and secondary leukemia side effects and should be explored further in randomized studies.
Abstracts by Priyanka Sharma:
Prognosis of triple negative breast cancer patients who attain pathological complete response with neoadjuvant carboplatin/docetaxel and do not receive adjuvant anthracycline chemotherapy.Meeting: 2016 ASCO Annual Meeting | Abstract No: 1015
- Meeting: 2015 ASCO Annual Meeting | Abstract No: 1039
Outcomes with neoadjuvant versus adjuvant chemotherapy for T1-2 node negative triple negative breast cancer.Meeting: 2015 ASCO Annual Meeting | Abstract No: 1092