Breast Cancer: Targets and Therapy (Mar 2022)
Weekly vs Every-3-Week Carboplatin with Weekly Paclitaxel in Neoadjuvant Chemotherapy for Triple-Negative Breast Cancer: A Retrospective Analysis
Abstract
Kara K Landry,1 Jessica L Lyon,2 Kitty E Victoria,1 P Nick Changizzadeh,3 Bernard F Cole,4 Bhargavi Pulluri,5 William M Sikov,6 Marie E Wood1 1Division of Hematology and Oncology, Department of Medicine, University of Vermont Medical Center, Burlington, VT, USA; 2Larner College of Medicine at the University of Vermont, Burlington, VA, USA; 3Hematology and Oncology, Eastern Connecticut Hematology and Oncology, Norwich, CT, USA; 4College of Engineering and Mathematical Sciences, University of Vermont, Burlington, VA, USA; 5Division of Hematology and Oncology, Saint Agnes Hospital, Baltimore, MD, USA; 6Women and Infants Hospital of Rhode Island, Program in Women’s Oncology, and Warren Alpert Medical School of Brown University, Providence, RI, USACorrespondence: Marie E Wood, Department of Medicine, Division of Hematology and Oncology, University of Vermont Medical Center, 111 Colchester Avenue, Burlington, VA, 05401, USA, Tel +1 802-847-8400, Email [email protected]: Adding carboplatin to weekly paclitaxel as part of neoadjuvant chemotherapy (NACT) for stage II–III triple negative breast cancer (TNBC) has been shown to significantly increase the pathologic complete response (pCR) rate. Hematologic toxicities associated with every 3-week dosing of carboplatin have led some oncologists to explore weekly dosing as an alternative, but there are little published data comparing the two dosing schedules.Methods: We performed a retrospective analysis of patients who received paclitaxel and carboplatin, usually followed by AC, as initial NACT for TNBC at two academic cancer centers between 2008 and 2018 for whom pathologic results and post-operative follow-up were available. We recorded pCR, defined as ypT0/isN0, treatment delivery and disease-free survival, censored as of the patient’s last follow-up visit.Results: A total of 76 patients were identified (median age 49 years). A total of 47 received weekly carboplatin, of whom 83% received at least 11 of 12 planned doses, and 29 received every 3-week carboplatin, of whom 90% received all 4 planned doses. pCR rates were similar, 53% with weekly and 55% with every 3-week carboplatin dosing. At median follow-up of 18 months (range < 1– 118), 93% of patients who achieved pCR were alive and free from recurrence, compared to 74% of those who did not.Conclusion: pCR rates were similar between patients receiving weekly or every 3-week carboplatin and were similar to those reported in prior trials with carboplatin. These data suggest that providers can choose either weekly or every 3-week carboplatin dosing without compromising the likelihood of achieving pCR.Keywords: triple negative breast cancer, neoadjuvant treatment, carboplatin dosing, chemotherapy
