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The US trial of 443 women that showed adding carboplatin to pre-surgery paclitaxel, doxorubicin and cyclophosphamide raised complete tumour disappearance in breast and nodes from 41 to 54 percent, at the cost of more low blood counts and skipped doses; it and GeparSixto made platinum standard.
CALGB 40603 (Alliance), a 2 by 2 factorial open-label randomised phase 2 trial by Sikov, Berry, Perou, Singh and colleagues, gave 443 patients with stage II to III triple-negative breast cancer weekly paclitaxel for 12 weeks then dose-dense doxorubicin and cyclophosphamide, randomised to concurrent carboplatin (area under the curve 6, four cycles) and/or bevacizumab (nine cycles). Patients assigned carboplatin or bevacizumab were less likely to complete chemotherapy without skipped doses, modification or discontinuation; grade 3 or higher neutropenia and thrombocytopenia were more common with carboplatin, and hypertension, infection, thromboembolism, bleeding and postoperative complications with bevacizumab. Carboplatin raised pathological complete response in the breast from 44 to 60 percent (p=0.0018) and in breast and axilla from 41 to 54 percent (p=0.0029); bevacizumab raised breast response (48 to 59 percent, p=0.0089) but not breast and axilla. No more-than-additive interaction was shown.
With GeparSixto, the trial that put carboplatin into the neoadjuvant triple-negative regimen; KEYNOTE-522's chemotherapy backbone is this one plus pembrolizumab. Bevacizumab, the other arm, left the field.
Shares Neoadjuvant carboplatin in patients with triple-negative and HER2-positive early breast cancer (GeparSixto; GBG 66): a randomised phase 2 trial, GeparSixto, Pathologic complete response (pCR), Triple-negative breast cancer roadmap: from a remainder defined by three negative tests to immunotherapy, antibody-drug conjugates and the residual disease problem and the tag tnbc-evidence.
Shares Pathologic complete response (pCR), Neoadjuvant / adjuvant / perioperative, Triple-negative breast cancer roadmap: from a remainder defined by three negative tests to immunotherapy, antibody-drug conjugates and the residual disease problem, Journal of Clinical Oncology and the tag tnbc-evidence.
Shares Neoadjuvant / adjuvant / perioperative, Cyclophosphamide, Triple-negative breast cancer roadmap: from a remainder defined by three negative tests to immunotherapy, antibody-drug conjugates and the residual disease problem, Doxorubicin and the tag tnbc-evidence.
Shares Pathologic complete response (pCR), Triple-negative breast cancer roadmap: from a remainder defined by three negative tests to immunotherapy, antibody-drug conjugates and the residual disease problem, Platinum agents, Paclitaxel / nab-paclitaxel and the tag tnbc-evidence.
Shares Pathologic complete response (pCR), Neoadjuvant / adjuvant / perioperative, Triple-negative breast cancer roadmap: from a remainder defined by three negative tests to immunotherapy, antibody-drug conjugates and the residual disease problem, Journal of Clinical Oncology and the tag tnbc-evidence.
Shares KEYNOTE-522, Triple-negative breast cancer roadmap: from a remainder defined by three negative tests to immunotherapy, antibody-drug conjugates and the residual disease problem, Platinum agents, Carboplatin and the tag tnbc-evidence.
Shares KEYNOTE-522, Triple-negative breast cancer roadmap: from a remainder defined by three negative tests to immunotherapy, antibody-drug conjugates and the residual disease problem, Journal of Clinical Oncology, Triple-negative breast cancer (TNBC) and the tag tnbc-evidence.
Shares Pathologic complete response (pCR), Neoadjuvant / adjuvant / perioperative, Triple-negative breast cancer roadmap: from a remainder defined by three negative tests to immunotherapy, antibody-drug conjugates and the residual disease problem, Journal of Clinical Oncology and the tag tnbc-evidence.