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Erschienen in: Breast Cancer Research and Treatment 1/2020

11.05.2020 | Clinical trial

Carboplatin plus taxanes are non-inferior to epirubicin plus cyclophosphamide followed by taxanes as adjuvant chemotherapy for early triple-negative breast cancer

verfasst von: Feng Du, Wenmiao Wang, Yongsheng Wang, Ming Li, Anjie Zhu, Jiayu Wang, Ruigang Cai, Fei Ma, Ying Fan, Qing Li, Pin Zhang, Vladimir Todorovic, Peng Yuan, Binghe Xu

Erschienen in: Breast Cancer Research and Treatment | Ausgabe 1/2020

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Abstract

Purpose

Platinum plays an important role in the treatment of triple-negative breast cancer (TNBC) in neoadjuvant and metastatic settings. However, its role in an adjuvant setting remains unclear.

Methods

In this non-inferior randomized phase 2 trial, we randomly assigned 308 chemotherapy-naive patients with histologically confirmed TNBC after primary surgery to receive either six cycles of TP (docetaxel: 75 mg/m2 or paclitaxel 175 mg/m2 d1; carboplatin AUC = 5, day 1), or four cycles of EC (epirubicin: 90 mg/m2; cyclophosphamide: 600 mg/m2, day 1) followed by four cycles of T (docetaxel: 75 mg/m2 or paclitaxel 175 mg/m2, day 1). The primary end point was the disease-free survival (DFS) rate at 5 years. Both regimens were repeated every 3 weeks. The prognostic and predictive value of germline breast cancer gene mutations and programmed death ligand-1 (PD-L1) expression was evaluated.

Results

At a median follow-up of 66.9 months, the 5-year DFS rate was 85.8% in the EC-T arm, and 84.4% in the TP arm (p non-inferiority = 0.034, p log-rank = 0.712). The 5-year overall survival (OS) rate was 94.4% in the EC-T arm and 93.5% in the TP arm (p = 0.770). Patients in the TP arm showed better compliance and experienced significantly lower frequencies of G3/4 neutrocytopenia and G3/4 alopecia, but higher rates of G1–4 thrombocytopenia than those in the EC-T arm. Patients with PD-L1 expressing tumors showed significantly improved DFS and OS.

Conclusions

This study indicates that carboplatin plus taxanes could be a feasible adjuvant chemotherapy for patients with early TNBC who are cannot tolerate intensive chemotherapy with anthracycline.
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Metadaten
Titel
Carboplatin plus taxanes are non-inferior to epirubicin plus cyclophosphamide followed by taxanes as adjuvant chemotherapy for early triple-negative breast cancer
verfasst von
Feng Du
Wenmiao Wang
Yongsheng Wang
Ming Li
Anjie Zhu
Jiayu Wang
Ruigang Cai
Fei Ma
Ying Fan
Qing Li
Pin Zhang
Vladimir Todorovic
Peng Yuan
Binghe Xu
Publikationsdatum
11.05.2020
Verlag
Springer US
Erschienen in
Breast Cancer Research and Treatment / Ausgabe 1/2020
Print ISSN: 0167-6806
Elektronische ISSN: 1573-7217
DOI
https://doi.org/10.1007/s10549-020-05648-9

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