Abstract
BackgroundBreast cancer (BC) is the leading cause of cancer death for Chilean women. About 11% of cases are triple-negative (TN) BC. These are characterised by poor prognosis, higher risk of early recurrence and visceral dissemination versus other BC subtypes. Current standard treatment for early-stage non-metastatic TNBC patients consists of neoadjuvant chemotherapy (NACT) followed by surgery and radiotherapy. Pathological complete response (pCR) to NACT is associated with an increase in survival rates. In general, NACT and adjuvant regimens involve similar cytotoxic drugs. Recent studies have postulated that the use of platinum compounds in TNBC would increase response rates. However, their effects on patient survival remain uncertain.Materials and methodsWe retrieved and analysed medical records from a total of 156 Chilean stage I–III TNBC female patients that received NACT and compared survival rates using carboplatin (Cb)-containing versus non-Cb-containing regimens at two health cancer centres.ResultsMedian age was 51 years (range: 24–81); 13.5% (n = 21) received Cb-containing regimens, 80.1% (n = 125) received sequential anthracyclines plus taxanes; 29.5% (n = 46) of the total group achieved pCR, 28% for the standard treatment and 35% (n = 8) for the Cb-containing group (p = 0.59). We confirmed pCR was associated with prolonged overall survival, invasive and distant disease-free survival (Log-rank p = 0.0236). But the addition of Cb was not associated with differences in survival measures (Log-rank p = 0.5216).ConclusionsTo the best of authors’ knowledge, this is the first report on real-world data in the Chilean population assessing the effect of Cb-containing NACT in TNBC. The authors’ results suggest no survival benefit by the addition of Cb to standard NACT. However, we confirm an increase in survival associated to pCR regardless of treatment.
Highlights
Breast cancer (BC) is the leading cause of cancer death for Chilean women
We confirmed Pathological complete response (pCR) was associated with prolonged overall survival, invasive and distant disease-free survival (Log-rank p = 0.0236)
To the best of authors’ knowledge, this is the first report on real-world data in the Chilean population assessing the effect of Cb-containing neoadjuvant chemotherapy (NACT) in triple negative breast cancers (TNBCs)
Summary
Breast cancer (BC) is the leading cause of cancer death for Chilean women. About 11% of cases are triple-negative (TN) BC. Recent reports in Western countries (including Chile) have revealed an increase in BC incidence [2,3,4] These could be explained by a combination of factors such as changes in lifestyles, mainly associated with an ageing population, increased exposure to hormones and obesity rates along with better diagnostic methods. Within this context, triple negative breast cancers (TNBCs) represent about 11% of cases in Chile. NACT improves breast conservation levels in TNBC [6] plus in vivo assessment of therapy response These regimens have failed to improve survival compared to adjuvant chemotherapy (CT) [6]. Recent studies have proposed its addition to regular NACT schemes, given the added toxicity and the uncertain overall survival (OS) benefit, this is still controversial in management guidelines [8,9,10]
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