Taxol and Carboplatin for Neoadjuvant Therapy – pro

Two independent phase II studies have shown that the combination of carboplatin and docetaxel (Taxotere®; Aventis Pharmaceuticals, Inc.; Bridgewater, NJ) is active in the first-line treatment of metastatic breast cancer. Based on these promising results, nonanthracycline alternatives were investigated, with many of them incorporating platinum agents. A recent review concluded: “In several phase II studies, combination carboplatin and paclitaxel (Taxol®; Bristol-Myers Squibb) therapy was active and reasonably well tolerated in the first-line treatment of metastatic breast cancer, producing objective response rates of 53%–62%—substantially higher rates than those seen in other phase II trials of either drug alone. Similar phase II data for carboplatin with docetaxel (Taxotere®; Aventis; Bridgewater, NJ) have been reported, and recent phase III data suggest that adding carboplatin to a paclitaxel/trastuzumab regimen produces superior efficacy than paclitaxel/trastuzumab alone for patients with HER2+ metastatic disease. Drug scheduling plays an important role in the therapeutic ratio of this combination treatment.”

There is less information on using this regimen for neoadjuvant therapy. There are Phase II studies that suggest the weekly schedule for the neoadjuvant settings. NCCN does not specifically list this regimen for neaodjuvant use. However, on p. BINV-12 NCCS says: “in general, dose chemotherapy regimens recommended in the adjuvant setting may be considered in the preoperative setting”. Nevertheless, and NCCN does not recommend this regimen in the adjuvant setting either.

J. W. Chia, P. Ang, H. See, Z. Wong, L. Soh, Y. Yap, N. Wong  Triple-negative metastatic/recurrent breast cancer: Treatment with paclitaxel/carboplatin combination chemotherapy. Journal of Clinical Oncology, 2007 ASCO Annual Meeting Proceedings Part I. Vol 25, No. 18S (June 20 Supplement), 2007: 1086

X. S. Chen et al, Weekly paclitaxel plus carboplatin is an effective nonanthracycline-containing regimen as neoadjuvant chemotherapy for breast cancer Ann Oncol (2010)
doi: 10.1093/annonc/mdq041, BINV-12 and BINV-K, 2012

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