{"entity":{"id":"neopact","kind":"trial","name":"NeoPACT","aka":[],"tldr":"NeoPACT tested a shorter, anthracycline-free pre-operative combination of carboplatin, docetaxel and pembrolizumab in triple-negative breast cancer. Tumours disappeared completely in 58 percent of women and 86 percent were free of events at three years, which is the basis for the SCARLET phase 3 comparison with the KEYNOTE-522 regimen.","summary":"NeoPACT (NCT03639948) was a single-arm phase 2 trial of 115 eligible patients (120 registered) with stage I to III triple-negative breast cancer enrolled from 2018 to 2022 at two US sites, who received neoadjuvant carboplatin AUC 6 and docetaxel 75 mg/m2 with pembrolizumab 200 mg every 21 days for six cycles with growth-factor support. Pathological complete response was 58 percent (95 percent confidence interval 48 to 67) and residual cancer burden 0 or 1 was 69 percent; grade 3 or higher immune-mediated adverse events occurred in 3.5 percent. Estimated three-year event-free survival was 86 percent overall, 98 percent after pathological complete response and 68 percent without it. Stromal TILs, PD-L1, the DNA damage immune response signature and the 27-gene tumour immune microenvironment signature each independently predicted response. The regimen is now the experimental arm of SWOG S2212 (SCARLET), which randomises it against the KEYNOTE-522 regimen with response-adapted adjuvant therapy in 2,400 patients.","status":"positive","asOf":"2026-09-24","links":[{"label":"ClinicalTrials.gov NCT03639948","url":"https://clinicaltrials.gov/study/NCT03639948"},{"label":"Sharma et al., JAMA Oncology 2024: NeoPACT clinical and biomarker findings","url":"https://doi.org/10.1001/jamaoncol.2023.5033"}],"tags":[],"related":[],"cancers":["tnbc","tnbc-early"],"sections":[],"technologies":["checkpoint-inhibitor","platinum","cytotoxic-chemotherapy"],"targets":[],"drugs":["carboplatin","docetaxel","pembrolizumab","pegfilgrastim"],"companies":["merck"],"institutions":[],"pathways":[],"terms":["pcr","rcb","tils","de-escalation"],"trials":["scarlet-s2212","keynote-522"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"nct":"NCT03639948","phase":"2","setting":"Stage I to III triple-negative breast cancer: neoadjuvant carboplatin and docetaxel with pembrolizumab for six cycles, anthracycline-free, single arm, two US sites","sponsor":"University of Kansas Medical Center, with Merck","result":"pCR 58% (48 to 67); RCB 0 or 1 69%; 3-year EFS 86% (98% with pCR, 68% without).","yearReported":2024,"enrolled":120,"enrolledBasis":"registry","outcomes":[{"endpoint":"Pathological complete response","primary":true,"unit":"%","arms":[{"name":"Carboplatin + docetaxel + pembrolizumab","n":115,"value":58}],"ci":[48,67],"source":"https://doi.org/10.1001/jamaoncol.2023.5033"},{"endpoint":"Event-free survival at 3 years","unit":"%","arms":[{"name":"All patients","value":86},{"name":"Pathological complete response","value":98},{"name":"No pathological complete response","value":68}],"source":"https://doi.org/10.1001/jamaoncol.2023.5033"}],"replication":"Being tested against the KEYNOTE-522 regimen in SWOG S2212 (SCARLET)."},"route":"/trials/neopact/","neighbours":{"cancer":[{"id":"tnbc-early","kind":"cancer","name":"Early triple-negative breast cancer","route":"/cancers/tnbc-early/"},{"id":"tnbc","kind":"cancer","name":"Triple-negative breast cancer (TNBC)","route":"/cancers/tnbc/"}],"technology":[{"id":"cytotoxic-chemotherapy","kind":"technology","name":"Cytotoxic chemotherapy","route":"/technologies/cytotoxic-chemotherapy/"},{"id":"checkpoint-inhibitor","kind":"technology","name":"Immune checkpoint inhibitors","route":"/technologies/checkpoint-inhibitor/"},{"id":"platinum","kind":"technology","name":"Platinum agents","route":"/technologies/platinum/"}],"drug":[{"id":"carboplatin","kind":"drug","name":"Carboplatin","route":"/drugs/carboplatin/"},{"id":"docetaxel","kind":"drug","name":"Docetaxel","route":"/drugs/docetaxel/"},{"id":"pegfilgrastim","kind":"drug","name":"Pegfilgrastim","route":"/drugs/pegfilgrastim/"},{"id":"pembrolizumab","kind":"drug","name":"Pembrolizumab","route":"/drugs/pembrolizumab/"}],"company":[{"id":"merck","kind":"company","name":"Merck & Co. (MSD)","route":"/companies/merck/"}],"term":[{"id":"de-escalation","kind":"term","name":"De-escalation, escalation and response-adapted therapy","route":"/terms/de-escalation/"},{"id":"pcr","kind":"term","name":"Pathologic complete response (pCR)","route":"/terms/pcr/"},{"id":"rcb","kind":"term","name":"Residual cancer burden (RCB)","route":"/terms/rcb/"},{"id":"tils","kind":"term","name":"Tumour-infiltrating lymphocytes (TILs)","route":"/terms/tils/"}],"trial":[{"id":"keynote-522","kind":"trial","name":"KEYNOTE-522","route":"/trials/keynote-522/"},{"id":"scarlet-s2212","kind":"trial","name":"SCARLET (SWOG S2212)","route":"/trials/scarlet-s2212/"}]}}