Carboplatin for triple negative breast cancer – pro
Triple-negative breast cancer has a poor prognosis. Paclitaxel and carboplatin is an established regimen in breast cancer.. Two trials, one conducted in the U.S. and one in Germany, showed that the addition of carboplatin to standard chemotherapeutic agents significantly improved the pCR rate in patients with triple-negative disease, and both showed that pCR correlated with better event-free (EFS), disease-free (DFS), and overall survival.
NCCN does not list this regimen on p. BINV-L, 2 and 3 on adjuvant and neo-adjuvant therapy, but there is literature to support it. NCCN does recommend a “platinum option” for metastatic or recurrent disease on p.BINV-Q, 1. By expressing it as “platinum option” rather than “cisplatin and carboplatin”, it is best interpreted to include the paclitaxel/ carbop0latin “option”.
San Antonio Breast Cancer Symposium,
Source Reference: Skov WM, et al “Event-free and overall survival following neoadjuvant weekly paclitaxel and dose-dense AC +/- carboplatin and/or bevacizumab in triple-negative breast cancer: Outcomes from CALGB 40603 (Alliance)” SABCS 2015; Abstract S2-05.
San Antonio Breast Cancer Symposium
Source Reference: Von Minckwitz G, et al “Early survival analysis of the randomized phase II trial investigating the addition of carboplatin to neoadjuvant therapy for triple-negative and HER2-positive early breast cancer (GeparSixto)” SABCS 2015; Abstract S2-04.
Omarini C, Guaitoli G, Pipitone S, et al. Neoadjuvant treatments in triple-negative breast cancer patients: where we are now and where we are going. Cancer Manag Res. 2018;10:91–103. Published 2018 Jan 15.
NCCN, Breast Cancer 2019