Dr. Tolaney on Platinum-Based Therapy in Neoadjuvant Setting of TNBC

Sara M. Tolaney, MD, MPH, physician, instructor in medicine, Harvard Medical School, medical oncologist, Dana-Farber Cancer Institute, discusses adding platinum-based therapy to the neoadjuvant setting for the treatment of patients with triple-negative breast cancer (TNBC).

A common question oncologists face when administering neoadjuvant treatment to patients with TNBC is whether or not to add platinum-based therapy, Tolaney explains. Currently, the standard neoadjuvant treatment is a taxane/anthracycline combination.

Randomized trials, such as the CALGB 40603/Alliance and GeparSixto studies, have sought to answer this question. The CALGB 40603/Alliance study found that there was a statistically significant improvement and pathologic complete response in adding carboplatin to a taxane/anthracycline combination. The GeparSixto study also showed these results. These findings suggest that a new standard of care should be considered in this setting, Tolaney adds; however, there is lack of long-term follow-up data to determine if it improves event-free or overall survival. Moreover, adding platinium-based therapy leads to an increase in toxicities, such as neutropenia and thrombocytopenia.