Multicenter Real-World Evaluation of Neoadjuvant Carboplatin in Triple-Negative Breast Cancer

Area of Science:

• Oncology
• Medical Research

Background:

• Neoadjuvant chemotherapy for triple-negative breast cancer (TNBC) is standard, but carboplatin's role is debated, especially with limited immunotherapy access.
• This study investigates the real-world impact of adding carboplatin to standard neoadjuvant chemotherapy for TNBC.

Purpose of the Study:

• To evaluate the effect of carboplatin on pathological complete response (pCR) in TNBC patients receiving neoadjuvant chemotherapy.
• To assess the impact of carboplatin on overall survival (OS) and disease-free survival (DFS) in TNBC.

Main Methods:

• Retrospective multicenter study of 142 nonmetastatic TNBC patients treated between 2018-2023.
• Patients received anthracycline- and taxane-based chemotherapy, with or without platinum (carboplatin).
• Kaplan-Meier, log-rank tests, Cox regression, and propensity score matching were used for survival analysis.

Main Results:

• Carboplatin use was associated with a significantly higher pCR rate (68.9% vs. 50.5%, p=0.031).
• While median OS and DFS were not reached, 60-month OS rates were higher in the platinum group (96.0% vs. 73.9%, p=0.027).
• Achieving pCR correlated with significantly better OS and DFS; propensity score matching supported these findings.

Conclusions:

• In real-world settings, carboplatin addition to neoadjuvant chemotherapy for TNBC is linked to improved pCR and numerically favorable survival outcomes.
• These results are particularly relevant for areas with restricted immunotherapy access.
• Further prospective validation is warranted to confirm these hypothesis-generating findings.