Taxotere/ carboplatin for adjuvant chemotherapy of breast cancer – pro
Adriamycin/Cytoxan (AC) has long been considered a standard adjuvant chemotherapy combination for the treatment of breast cancer. Thirty years ago, results were published that established AC as the standard adjuvant treatment for breast cancer.
The next improvement on AC was to add paclitaxel or docetaxel in various schedules. Since then, however, it has been noted that the anthracycline is associated with risks of cardiotoxicity, particularly in patients with underlying cardiac issues or the elderly. Furthermore, Taxotere has demonstrated greater anti-tumor activity than Adriamycin in women with advanced breast cancer. NCCN only recomemnds it with Herceptin, which si nto an option for this tripel-negative patient.
In addition, there is early evidence that this regimen might work better in triple negative disease. However, ASCO sayd: ” Although preoperative trials have demonstrated that adding platinum therapy to an anthracycline-and-taxane backbone improves pathologic complete response, these studies were not powered to evaluate survival outcomes and also noted higher rates of treatment discontinuation and myelosuppression.10,11 At this time, the guideline does not recommend the routine use of platinum therapy in patients receiving preoperative or adjuvant chemotherapy for triple-negative breast cancer and rather recommend awaiting results of the ongoing trial that is evaluating this question (NRG-BR003). ■ “.
http://www.ascopost.com/issues/august-25-2016/asco-guideline-addresses-controversial-areas-in-adjuvant-therapy-for-breast-cancer/
The ASCO Post Aug 25, 2016
NCCN, Breast, BINV-K 2019
Sikov WM, Berry DA, Perou CM, et al: Impact of the addition of carboplatin and/or bevacizumab to neoadjuvant once-per-week paclitaxel followed by dose-dense doxorubicin and cyclophosphamide on pathologic complete response rates in stage II to III triple-negative breast cancer: CALGB 40603 (Alliance). J Clin Oncol 33:13-21, 2015.
von Minckwitz G, Schneeweiss A, Loibl S, et al: Neoadjuvant carboplatin in patients with triple-negative and HER2-positive early breast cancer (GeparSixto; GBG 66): A randomised phase 2 trial. Lancet Oncol 15:747-756, 2014.