De-escalation neoadjuvant chemotherapy in triple negative breast cancer.

Abstract

e12520 Background: Neoadjuvant chemotherapy (NAT) represents the predominant therapeutic approach in the early triple negative breast cancer. NAT has demonstrated high overall survival rates in patients that achieve a pathological complete response (pCR). In patients with a tumor size less than 5 cm and no involvement of axillary lymph nodes, it may be advisable to consider a shorter chemotherapy regimen to evaluate the achievement of pCR percentages compared to longer regimens. Methods: We conducted an analysis of a cohort comprising 62 patients with triple-negative breast cancer in stages I and II that received 4 cycles of NAT with paclitaxel 80 mg/m2 weekly for 12 weeks plus carboplatin in AUC 5 doses every three weeks. Results: The median age within the cohort was 61 years (32-83) with an initial tumor size of 22 mm (10-82) and Ki67 expression of 54% (13-90). Ten patients (16%) presented histologically confirmed initial axillary involvement. The group attained a pCR rate of 56% while only 21% exhibited a minor response with a residual tumor exceeding 10 mm. Over a median follow-up period of 34 months, the recurrence rate was only 5%. The distribution of pathological response across the different clinical variables is delineated in the Table. Conclusions: The NAT regimen with carboplatin AUC 5 + weekly paclitaxel (80 mg/m2) for four cycles is safe for patients diagnosed with stage I and II, demonstrating a high pCR (56%) and a lower recurrence rate (5%). The pathological response observed across all clinical variable subgroups suggests that this regimen could be considered a potential standard for NAT in patients with stage I and II triple-negative breast cancer. [Table: see text]