Incorporating weekly carboplatin in anthracycline and paclitaxel-containing neoadjuvant chemotherapy for triple-negative breast cancer: propensity-score matching analysis and TIL evaluation.

Autor: Dieci MV; Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy. mariavittoria.dieci@unipd.it.; Division of Medical Oncology 2, Istituto Oncologico Veneto IRCCS, Padova, Italy. mariavittoria.dieci@unipd.it., Carbognin L; Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Roma, Italy., Miglietta F; Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy.; Division of Medical Oncology 2, Istituto Oncologico Veneto IRCCS, Padova, Italy., Canino F; Department of Medical and Surgical Sciences for Children and Adults, University Hospital of Modena, Modena, Italy., Giorgi CA; Division of Medical Oncology 2, Istituto Oncologico Veneto IRCCS, Padova, Italy., Cumerlato E; Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy.; Division of Medical Oncology 2, Istituto Oncologico Veneto IRCCS, Padova, Italy., Amato O; Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy.; Division of Medical Oncology 2, Istituto Oncologico Veneto IRCCS, Padova, Italy., Massa D; Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy.; Division of Medical Oncology 2, Istituto Oncologico Veneto IRCCS, Padova, Italy., Griguolo G; Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy.; Division of Medical Oncology 2, Istituto Oncologico Veneto IRCCS, Padova, Italy., Genovesi E; Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy.; Division of Medical Oncology 2, Istituto Oncologico Veneto IRCCS, Padova, Italy., Garufi G; Università Cattolica del Sacro Cuore, Roma, Italy., Giannarelli D; Istituto Nazionale Tumori Regina Elena, Roma, Italy., Tornincasa A; Department of Medical and Surgical Sciences for Children and Adults, University Hospital of Modena, Modena, Italy., Trudu L; Department of Medical and Surgical Sciences for Children and Adults, University Hospital of Modena, Modena, Italy., Michieletto S; Breast Surgery Department, Istituto Oncologico Veneto IRCCS, Padova, Italy., Saibene T; Breast Surgery Department, Istituto Oncologico Veneto IRCCS, Padova, Italy., Lo Mele M; Surgical Pathology Unit, University Hospital of Padova, Padova, Italy., Fassan M; Department of Medicine (DIMED), Surgical Pathology & Cytopathology Unit, University of Padua, Padova, Italy.; Istituto Oncologico Veneto IRCCS, Padova, Italy., Zarrilli G; Department of Medicine (DIMED), Surgical Pathology & Cytopathology Unit, University of Padua, Padova, Italy., Piacentini F; Department of Medical and Surgical Sciences for Children and Adults, University Hospital of Modena, Modena, Italy., Bria E; Università Cattolica del Sacro Cuore, Roma, Italy.; Comprehensive Cancer Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy., Guarneri V; Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy.; Division of Medical Oncology 2, Istituto Oncologico Veneto IRCCS, Padova, Italy.
Jazyk: angličtina
Zdroj: British journal of cancer [Br J Cancer] 2023 Jan; Vol. 128 (2), pp. 266-274. Date of Electronic Publication: 2022 Nov 17.
DOI: 10.1038/s41416-022-02050-8
Abstrakt: Background: The generation of data capturing the risk-benefit ratio of incorporating carboplatin (Cb) to neoadjuvant chemotherapy (NACT) for triple-negative breast cancer (TNBC) in a clinical practice setting is urgently needed. Tumour-infiltrating lymphocytes (TILs) have an established role in TNBC receiving NACT, however, the role of TIL dynamics under NACT exposure in patients receiving the current standard of care is largely uncharted.
Methods: Consecutive TNBC patients receiving anthracycline-taxane [A-T] +/- Cb NACT at three Institutions were enrolled. Stromal-TILs were evaluated on pre-NACT and residual disease (RD) specimens. In the clinical cohort, propensity-score-matching was used to control selection bias.
Results: In total, 247 patients were included (A-T = 40.5%, A-TCb = 59.5%). After propensity-score-matching, pCR was significantly higher for A-TCb vs A-T (51.9% vs 34.2%, multivariate: OR = 2.40, P = 0.01). No differences in grade ≥3 haematological toxicities were observed. TILs increased from baseline to RD in the overall population and across A-T/A-TCb subgroups. TIL increase from baseline to RD was positively and independently associated with distant disease-free survival (multivariate: HR = 0.43, P = 0.05).
Conclusions: We confirmed in a clinical practice setting of TNBC patients receiving A-T NACT that the incorporation of weekly Cb significantly improved pCR. In addition, A-T +/- Cb enhanced immune infiltration from baseline to RD. Finally, we reported a positive independent prognostic role of TIL increase after NACT exposure.
(© 2022. The Author(s).)
Databáze: MEDLINE
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