Platinum Chemo Improves TNBC Survival for Patients Younger Than 50

In a phase III trial, researchers randomized 717 patients with nonmetastatic TNBC to receive either standard sequential taxane-anthracycline neoadjuvant chemotherapy alone (n = 356) or in combination with carboplatin (n = 361). Patients’ median age was 46 years (range = 25–69), and 69.7% were 50 years or younger.

Among patients aged 50 or younger, the pathologic complete response (pCR) rate was 61.0% in the carboplatin arm and 41.5% in the standard treatment arm. Among patients older than 50 years, the pCR rates were 38.1% and 37.5%, respectively. After a median follow-up of 67.6 months, the five-year event-free survival rate was 74.2% in the carboplatin arm and 61.7% in the standard therapy arm for younger patients and 62.0% and 69.3%, respectively, for older patients. Comparatively, the five-year overall rate was 77.1% in the carboplatin arm and 65.9% in the standard therapy arm for younger patients and 68.0% in the and 68.9%, respectively, for older patients.

Grade 3 or higher hematologic adverse events were higher in the carboplatin arm than in the control arm, including neutropenia (8.6% versus 2.0%), anemia (1.9% versus 0.3%), thrombocytopenia (1.9% versus 0%), and febrile neutropenia (4.4% versus 2.8%). Serious adverse events occurred in 14.7% of patients in the carboplatin arm and 12.9% in the control arm.

“This study, to our knowledge the largest reported trial of neoadjuvant platinum in TNBC thus far, suggests that addition of carboplatin to sequential taxane-anthracycline neoadjuvant chemotherapy results in substantial and clinically meaningful improvement in disease-free and overall survival in young patients with TNBC and should be the standard of care in these patients,” the researchers concluded.

ONS’s Breast Cancer: Staying Up to Date course (https://www.ons.org/courses/breast-cancer-staying-date) can help you keep current with the latest breast cancer nursing practice changes.