Call for assessing treatment-induced gonadotoxicity of platinum-based chemotherapy in early breast cancer

Excerpt

We read with great interest the results of the randomized non-inferiority phase II trial recently published by Du and colleagues comparing the efficacy of a regimen with carboplatin plus a taxane with a standard anthracycline- and taxane-based regimen as adjuvant treatment of patients with early triple-negative breast cancer (TNBC) [1]. In this trial, 308 patients with TNBC were randomly assigned to receive either six cycles of a taxane (docetaxel 75 mg/m² or paclitaxel 175 mg/m²) plus carboplatin AUC 5 (TP regimen) or four cycles of epirubicin 90 mg/m² plus cyclophosphamide 600 mg/m² (EC) followed by four cycles of a taxane (docetaxel 75 mg/m² or paclitaxel 175 mg/m², T). At a median follow-up of 66.9 months, no statistically significant differences in survival outcomes were observed between the two regimens. In the EC-T and TP arms, respectively, 5-year disease-free survival was 85.8% (95% CI 80–91%) and 84.4% (95% CI 79–90%), while 5-year overall survival (OS) was 94.4% (95% CI 91–98%) and 93.5% (95% CI 90–97). A non-significant trend for higher benefit with TP than EC-T was observed in the cohort of 15 BRCA-mutated patients. Compliance to treatment was lower in the EC-T arm as compared to the TP arm. Patients in the EC-T arm experienced more often hematologic and non-hematologic toxicities as compared to those in the TP arm with the exception of thrombocytopenia [1]. …