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Weekly vs Every-3-Week Carboplatin with Weekly Paclitaxel in Neoadjuvant Chemotherapy for Triple-Negative Breast
Kara K Landry1, Jessica L Lyon2, Kitty E Victoria1
1Division of Hematology and Oncology, Department of Medicine, University of Vermont Medical Center, Burlington, VT, USA.
Breast Cancer (Dove Medical Press)
|March 22, 2022
Summary
Weekly or every 3-week carboplatin dosing shows similar pathologic complete response (pCR) rates for triple-negative breast cancer (TNBC) neoadjuvant chemotherapy. This finding suggests flexibility in carboplatin scheduling without impacting treatment efficacy for TNBC patients.
Area of Science:
- Oncology
- Medical Research
- Clinical Trials
Background:
- Neoadjuvant chemotherapy (NACT) with paclitaxel and carboplatin improves pathologic complete response (pCR) rates in stage II-III triple-negative breast cancer (TNBC).
- Hematologic toxicities from every 3-week carboplatin dosing prompt investigation into weekly carboplatin schedules.
- Limited data exist comparing the efficacy and safety of weekly versus every 3-week carboplatin dosing in NACT for TNBC.
Purpose of the Study:
- To compare the pathologic complete response (pCR) rates between weekly and every 3-week carboplatin dosing in neoadjuvant chemotherapy for TNBC.
- To evaluate treatment delivery and disease-free survival in patients receiving different carboplatin schedules.
- To provide evidence-based guidance on carboplatin dosing strategies for TNBC NACT.
Main Methods:
- Retrospective analysis of 76 patients with stage II-III TNBC receiving NACT (paclitaxel and carboplatin, often followed by AC) between 2008-2018.
- Data collected included pCR (ypT0/isN0), treatment delivery, and disease-free survival.
- Patients were categorized based on receiving either weekly or every 3-week carboplatin dosing.
Main Results:
- pCR rates were comparable: 53% for weekly carboplatin and 55% for every 3-week carboplatin.
- Treatment delivery was high for both schedules (83% for weekly, 90% for every 3-week).
- Patients achieving pCR had significantly better disease-free survival (93% alive and recurrence-free vs. 74% without pCR).
Conclusions:
- Weekly and every 3-week carboplatin dosing yield similar pCR rates in TNBC NACT.
- Carboplatin dosing schedule can be chosen based on clinical judgment without compromising pCR.
- Findings align with previous studies, supporting flexibility in carboplatin administration for TNBC neoadjuvant therapy.
