Early TNBC: is carboplatin plus taxane an alternative to anthracycline plus taxane?

  • Du F & al.
  • Breast Cancer Res Treat
  • 11 May 2020

  • curated by Miriam Davis, PhD
  • Univadis Clinical Summaries
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Takeaway

  • A randomized controlled trial (RCT) of patients with early triple-negative breast cancer (TNBC) has shown that 5-year DFS with adjuvant carboplatin plus taxane is noninferior to DFS with standard anthracycline plus taxane.

Why this matters

  • Many patients with early TNBC cannot tolerate standard anthracycline-based chemotherapy, and alternative chemotherapy regimens are needed.

Study design

  • Phase 2, multicenter RCT (N=308) of 6 cycles of TP (docetaxel or paclitaxel plus carboplatin) vs 4 cycles of EC-T (epirubicin and cyclophosphamide) followed by 4 cycles of T (docetaxel or paclitaxel).
  • Primary outcome was DFS at 5 years posttherapy.
  • Funding: Cancer Foundation of China; National Natural Science Foundation; other.

Key results

  • Median follow-up was 66.9 months.
  • 5-year DFS:
    • 85.8% in EC-T group vs 84.4% in the TP group.
    • Pnoninferiority=.034.
    • Plog-rank=.712.
  • The TP vs EC-T group was more likely to finish scheduled treatment (84.4% vs 75.4%; P=.047).
  • The TP vs EC-T group had a lower frequency of grade 3/4 neutrocytopenia and alopecia (both P<.001 a higher frequency of grades thrombocytopenia>

Limitations

  • Imbalance in taxanes between groups, with more patients receiving docetaxel in the TP group than in the EC-T group.