Friday, September 15, 2023

Triple negative breast cancer Early stage

 1. Dose dense regimen

Use of DDAC followed by taxol- EFS and OS benefit shown in the CALGB/intergroup trial 2003 82% versus 75% DD group versus 3 week dose at 4 yr cut off.

2. Weekly taxol:

ECOG 1199 study demonstrated that once weekly paclitaxel 80 mg/m2 improved disease-free survival (DFS; HR, 0.69; P = .001) and OS (HR, 0.69; P = .019) compared with once every 3-weeks paclitaxel 175 mg/m2 administration.

3. Adjuvant after pembro based regimen Keynote 522

- if path CR--> ct pembro

-if no path CR, capecitabine if no germline BRCA, otherwise olaparib. If pre op pembro ct pembro.

CREATE-X trial as adjuvant treatment with capecitabine (1,250 mg/m2 PO twice a day days 1-14, 6-8 cycles) improved OS of patients with TNBC and residual invasive disease after NAC when compared with observation (HR, 0.52)

Olympia trial : After a median follow-up of 2.5 years, the 3-year DDFS was 87.5% in the olaparib group and 80.4% in the placebo group (7.1% difference)

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