Abstract

Triple-negative breast cancer (TNBC) is highly responsive to neoadjuvant polychemotherapy regimens including anthracyclines, taxanes, and, more recently, carboplatin. However, there is inadequate information on the individual contribution of each of these agents to the global activity of the combinations, and the use of combinations of up to four of these drugs is associated with relevant toxicity. Identifying single-drug activity in the clinical neoadjuvant setting is challenging. We developed patient-derived xenografts (PDXs) from several chemotherapy-naïve TNBC samples to assess the antitumor activity of single drugs and combinations of drugs. PDXs were established from chemotherapy-naïve TNBC samples. Nine TNBC PDX models (all of which corresponded to a basal-like phenotype according to the PAM50 classifier) were treated with carboplatin, docetaxel, and doxorubicin and the combination of docetaxel and carboplatin. Only one of nine PDX models showed sensitivity to doxorubicin, while eight of nine PDX models showed sensitivity to docetaxel and carboplatin as single agents. The 3 PDX models derived from patients with gBRCA-1 or gPALB2 mutations were very sensitive to carboplatin single agent. All 6 PDX models from patients without hereditary germ-line mutations showed increased sensitivity to the combination of docetaxel and carboplatin. In the present study, docetaxel and carboplatin single agents were active drugs against basal-like TNBC, while doxorubicin monotherapy showed low activity. The combination of docetaxel and carboplatin was more effective than the drugs used as single agents, except in the PDX from patients with gBRCA1/PALB2 mutations.

Highlights

  • Triple-negative breast cancer (TNBC) is highly responsive to neoadjuvant polychemotherapy regimens including anthracyclines, taxanes, and, more recently, carboplatin

  • We selected tumors from nine patients with or without germline BRCA1 and PALB2 mutations with different pathological responses to chemotherapy to correlate the results in patient-derived xenografts (PDXs) with the patients responses

  • The same experiment was performed in all 9 PDX models

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Summary

Introduction

Triple-negative breast cancer (TNBC) is highly responsive to neoadjuvant polychemotherapy regimens including anthracyclines, taxanes, and, more recently, carboplatin. We developed patient-derived xenografts (PDXs) from several chemotherapy-naïve TNBC samples to assess the antitumor activity of single drugs and combinations of drugs. Classical neoadjuvant chemotherapy for TNBC includes anthracycline-cyclophosphamide-taxane combinations and induces pathological complete responses (pCRs) in breast plus axilla in approximately one-third of patients with T­ NBC6. Carboplatin has been incorporated into neoadjuvant regimens for TNBC to increase the antitumor activity, and this incorporation translates into a higher pCR rate than those obtained using classical r­ egimens[7,8] All these chemotherapeutic agents have significant toxicity to the combination regimen. We engrafted several chemotherapy-naïve TNBC samples from patients with breast cancer to NOD.Cg-Prkdcscid IL2rgtm1Wjl (NSG) mice to assess the antitumor activity of single drugs and combinations of drugs and correlate the results with the clinical and pathological responses to the drugs in donor patients

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