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Carboplatin Neoadjuvant TNBC — SCE Medical Oncology MCQ

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ModerateBreast CancerCarboplatin Neoadjuvant TNBCSCE Medical Oncology

A 45-year-old BRCA1 carrier with newly diagnosed TNBC is offered neoadjuvant carboplatin in addition to standard anthracycline-taxane chemotherapy. What trial supports the addition of carboplatin in TNBC?

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Correct answer: B — The GeparSixto and BrighTNess trials demonstrated that adding carboplatin to neoadjuvant chemotherapy significantly increases pCR rates in TNBC (from ~37% to ~53%) — the benefit is particularly strong in BRCA-mutant TNBC

Adding carboplatin to neoadjuvant anthracycline-taxane chemotherapy for TNBC increases pCR rates by approximately 15-18% absolute (GeparSixto, CALGB 40603, BrighTNess). The BrighTNess trial showed the pCR benefit was maintained regardless of BRCA status, though BRCA-mutant patients had the highest pCR rates. Higher pCR rates correlate with improved event-free survival in TNBC. The trade-off is increased haematological toxicity. This is now incorporated into many neoadjuvant TNBC protocols.

Reference: ESMO 2024 Early Breast Cancer; BrighTNess Loibl et al Lancet Oncol 2018; GeparSixto