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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.
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.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
120 enrolled.
| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Pathological complete responseprimary | Carboplatin + docetaxel + pembrolizumab | 115 | 58% | - | - | link |
| Event-free survival at 3 years | All patients | - | 86% | - | - | link |
| Pathological complete response | - | 98% | ||||
| No pathological complete response | - | 68% |
Shares Residual cancer burden (RCB), KEYNOTE-522, Pathologic complete response (pCR), Early triple-negative breast cancer.
Shares Early triple-negative breast cancer, Platinum agents, Merck & Co. (MSD), Carboplatin.
Shares Early triple-negative breast cancer, Platinum agents, Carboplatin, Pembrolizumab.
Shares Docetaxel, Early triple-negative breast cancer, Platinum agents, Carboplatin.
Shares De-escalation, escalation and response-adapted therapy, KEYNOTE-522, Platinum agents, Carboplatin.
Shares Early triple-negative breast cancer, Platinum agents, Carboplatin, Pembrolizumab.
Shares Early triple-negative breast cancer, Platinum agents, Carboplatin, Pembrolizumab.
Shares Early triple-negative breast cancer, Platinum agents, Carboplatin, Pembrolizumab.