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

The role of carboplatin in neoadjuvant chemotherapy for triple-negative breast cancer (TNBC) remains controversial, particularly in settings where access to immunotherapy is limited. This study evaluated the real-world impact of adding carboplatin to neoadjuvant chemotherapy on pathological complete response (pCR) and survival outcomes in patients with TNBC.

This retrospective multicenter study included patients with nonmetastatic TNBC treated with neoadjuvant anthracycline- and taxane-based chemotherapy between 2018 and 2023 at three oncology centers in Turkey. Patients were grouped according to receipt of platinum-containing therapy. Survival outcomes were estimated using the Kaplan-Meier method and compared with the log-rank test. Cox regression analyses were performed to evaluate factors associated with survival. Propensity score matching was also performed as a supportive analysis.

A total of 142 patients were included, of whom 45 (32.2%) received platinum-containing neoadjuvant chemotherapy. Overall, 80 patients (56.3%) achieved pCR. The pCR rate was significantly higher in the platinum group than in the non-platinum group (68.9% vs. 50.5%, p = 0.031). After a median follow-up of 57 months, 24 deaths and 33 DFS events were observed. Median OS and DFS were not reached. The 60-month OS rate was 96.0% in the platinum group and 73.9% in the non-platinum group (log-rank p = 0.027), whereas the 60-month DFS rates were 86.1% and 67.6%, respectively (log-rank p = 0.139). Patients who achieved pCR had significantly better OS and DFS than those with residual disease. In the propensity score-matched cohort, non-platinum treatment remained associated with inferior OS and DFS.

In this multicenter real-world cohort, carboplatin was associated with a higher pCR rate and numerically favorable survival outcomes. These findings may be clinically relevant where immunotherapy is not readily accessible but should be considered hypothesis-generating and require prospective validation.