Moment of truth-adding carboplatin to neoadjuvant/adjuvant chemotherapy in triple negative breast cancer improves overall survival: An individual participant data and trial-level Meta-analysis

Pathak, Neha; Sharma, Aparna; Elavarasi, Arunmozhimaran; Sankar, Jhuma; Deo, S. V. S.; Sharma, Daya Nand; Mathur, Sandeep; Kumar, Sudhir; Prasad, Chandra Prakash; Kumar, Akash; Batra, Atul

doi:10.1016/j.breast.2022.04.006

Cited by 18 publications

(11 citation statements)

References 40 publications

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“…A recent meta-analysis of clinical trials comparing addition of carboplatin to the standard anthracycline-taxane regimen showed benefit in DFS (HR: 0.60; 95% CI: 0.47-0.78; p < .001) and OS (HR: 0.69, 95% CI: 0.50-0.95; p = .02). 54 Therefore, addition of a platinum agent to standard neoadjuvant chemotherapy should be a shared informed decision, integrating the grade of toxicity that patient is able/willing to tolerate and the clinicopathological features of the disease.…”

Section: Discussionmentioning

confidence: 99%

Evolving Evidence for the Optimization of Neoadjuvant Therapy in Triple-Negative Breast Cancer

Silva

Mesquita

2022

Breast Cancer�(Auckl)

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Representing 15% to 20% of all invasive breast cancers, adjuvant systemic treatment for early-stage, high-risk triple-negative breast cancer (TNBC) is preferentially done in the neoadjuvant setting based on a chemotherapy backbone of anthracyclines and taxanes. Pathological complete response to neoadjuvant treatment constitutes the main objective, regarding its correlation with oncological outcomes. The optimal neoadjuvant regimen to achieve the highest rates of pathological complete response is still under investigation, with the increasing knowledge on the molecular pathways, genomic sequencing, and immunological profile of TNBC allowing for the development of a wide array of new therapeutic options. This review aims to summarize the current evidence and ongoing clinical trials of new therapeutic options for the neoadjuvant treatment of TNBC patients.

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Section: Discussionmentioning

confidence: 99%

Evolving Evidence for the Optimization of Neoadjuvant Therapy in Triple-Negative Breast Cancer

Silva

Mesquita

2022

Breast Cancer�(Auckl)

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“…Importantly, a very recent trial-level and patient-level meta-analysis further confirmed that the addition of carboplatin to standard anthracycline/taxane-based (neo)adjuvant chemotherapy was able to improve pCR rates, but also showed for the first time a clear benefit in terms of DFS and OS [ 30 ].…”

Section: Pathological Response After Different Nact Regimens and Pote...mentioning

confidence: 99%

Updated Neoadjuvant Treatment Landscape for Early Triple Negative Breast Cancer: Immunotherapy, Potential Predictive Biomarkers, and Novel Agents

Garufi

Carbognin

Schettini

et al. 2022

Cancers

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Triple-negative breast cancer (TNBC) is characterized by the absence of hormone receptor and HER2 expression, and therefore a lack of therapeutic targets. Anthracyclines and taxane-based neoadjuvant chemotherapy have historically been the cornerstone of treatment of early TNBC. However, genomic and transcriptomic analyses have suggested that TNBCs include various subtypes, characterized by peculiar genomic drivers and potential therapeutic targets. Therefore, several efforts have been made to expand the therapeutic landscape of early TNBC, leading to the introduction of platinum and immunomodulatory agents into the neoadjuvant setting. This review provides a comprehensive overview of the currently available evidence regarding platinum agents and immune-checkpoint-inhibitors for the neoadjuvant treatment of TNBC, as well as the novel target therapies that are currently being evaluated in this setting. Taking into account the economic issues and the side effects of the expanding therapeutic options, we focus on the potential efficacy biomarkers of the emerging therapies, in order to select the best therapeutic strategy for each specific patient.

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“…This study is estimated to have a primary completion date in November 2023 and will provide important insight into the role of platinum therapy in the adjuvant setting. A recent meta-analysis (looking at 2425 patients across eight clinical trials in the neoadjuvant and adjuvant settings) showed improvements in disease-free survival and overall survival with the addition of carboplatin to an anthracycline/taxane backbone, both with trial-level and individual patient-level analyses [ 37 ]. Overall, at this time, outside of clinical trials, the role of platinum chemotherapy in TNBC is primarily restricted to the neoadjuvant setting.…”

Section: Cytotoxic Chemotherapymentioning

confidence: 99%

Triple-Negative Breast Cancer: A Review of Current Curative Intent Therapies

2022

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Breast cancer is the most commonly diagnosed malignancy in women, with triple-negative breast cancer (TNBC) accounting for 10–20% of cases. Historically, fewer treatment options have existed for this subtype of breast cancer, with cytotoxic chemotherapy playing a predominant role. This article aims to review the current treatment paradigm for curative-intent TNBC, while also reviewing potential future developments in this landscape. In addition to chemotherapy, recent advances in the understanding of the molecular biology of TNBC have led to promising new studies of targeted and immune checkpoint inhibitor therapies in the curative-intent setting. The appropriate selection of TNBC patient subgroups with a higher likelihood of benefit from treatment is critical to identify the best treatment approach.

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Moment of truth-adding carboplatin to neoadjuvant/adjuvant chemotherapy in triple negative breast cancer improves overall survival: An individual participant data and trial-level Meta-analysis

Cited by 18 publications

References 40 publications

Evolving Evidence for the Optimization of Neoadjuvant Therapy in Triple-Negative Breast Cancer

Evolving Evidence for the Optimization of Neoadjuvant Therapy in Triple-Negative Breast Cancer

Updated Neoadjuvant Treatment Landscape for Early Triple Negative Breast Cancer: Immunotherapy, Potential Predictive Biomarkers, and Novel Agents

Triple-Negative Breast Cancer: A Review of Current Curative Intent Therapies

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