Prognosis of triple negative breast cancer patients who attain pathological complete response with neoadjuvant carboplatin/docetaxel and do not receive adjuvant anthracycline chemotherapy.

Authors

null

Priyanka Sharma

University of Kansas Medical Center, Westwood, KS

Priyanka Sharma , Bruce F. Kimler , Claire Ward , Anne O'Dea , Marc Steven Hoffmann , Jennifer R. Klemp , Marilee McGinness , Jamie Lynn Wagner , Joshua Mammen , Amanda Leigh Amin , Carolyn Lehn , Roy A. Jensen , Andrew K. Godwin , Qamar J. Khan

Organizations

University of Kansas Medical Center, Westwood, KS, University of Kansas Cancer Center, Westwood, KS, University of Kansas, Olathe, KS, University of Kansas Medical Center, Kansas City, KS, The University of Kansas Cancer Center, Kansas City, KS

Research Funding

Other

Background: Pathological complete response (pCR) in TNBC is associated with excellent long term survival. Recent studies demonstrate that addition of neoadjuvant (NA) carboplatin (Cb) to anthracycline/taxane chemotherapy improves pCR in TNBC. The prognostic value of pCR attained with anthracycline-free platinum/taxane chemotherapy in TNBC is not well known. Aims: To determine the long term outcomes in TNBC patients treated with NA Cb + Docetaxel (D). Methods: 443 patients with stage I (T>1cm), II, or III TNBC were enrolled in a prospective multisite registry between 2011-2015, out of which 76 patients received NA chemotherapy regimen of Cb(AUC 6) + D(75 mg/m2) q 21 days (4-6 cycles). pCR (no evidence of invasive tumor in the breast and axilla) and Residual Cancer Burden (RCB) was evaluated and patients were followed for recurrence and survival. Results: For the 76 eligible patients, median age: 52 yrs, African-American:16%, median tumor size: 3 cm, 33% LN positive and 25% with germline BRCA mutation. 88% of patients received 6 cycles of chemotherapy. pCR and RCB 0/1 rates were 66% (50/76) and 80% (61/76) respectively. Patients achieving pCR did not receive additional adjuvant chemotherapy. 73% of patients with RCB 2/3 received adjuvant chemotherapy. At a median follow up of 2.3 (range 0.5 - 7.8) years the RFS is 88% in the entire cohort. RFS is 95% and 76% in patients with and without pCR, respectively (HR: 0.14, p=0.014) and 94% and 68% in patients with RCB 0/1 and RCB 2/3 respectively (HR: 0.19, p=0.029). On univariate analysis higher stage, node positive status and lack of pCR were associated with a worse RFS. BRCA mutation status did not impact pCR or RFS Conclusions: NA CbD chemotherapy yields encouraging pCR rates (66%) in patients with TNBC; patients achieving pCR with this regimen demonstrate excellent RFS (95% at 2.3 years) without adjuvant anthracycline chemotherapy. The RFS of 76% in patients without pCR is consistent with known literature. For TNBC patients achieving pCR with NA CbD, adjuvant anthracycline can be avoided. Prospective studies to evaluate the efficacy of neoadjuvant platinum + taxane regimen in TNBC are needed.

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Abstract Details

Meeting

2016 ASCO Annual Meeting

Session Type

Poster Discussion Session

Session Title

Breast Cancer—Triple-Negative/Cytotoxics/Local Therapy

Track

Breast Cancer

Sub Track

Triple-Negative Breast Cancer

Citation

J Clin Oncol 34, 2016 (suppl; abstr 1015)

DOI

10.1200/JCO.2016.34.15_suppl.1015

Abstract #

1015

Poster Bd #

120

Abstract Disclosures