Do you advocate for dose dense AC instead of every 3 week dosing in neoadjuvant TNBC as done in KEYNOTE 522?

When giving neoadjuvant therapy for TNBC as given in the KEYNOTE-522 study, I prefer to administer dose dense AC (with growth factor support) + pembrolizumab (after completing weekly paclitaxel and carboplatin + pembrolizumab). While there has been no comparison of dose dense vs. q3week AC with this specific regimen (with the addition of carboplatin and pembrolizumab to paclitaxel and AC in TNBC), the EBCTCG meta-analysis of the impact of dose intensity (Lancet 2019) demonstrated the superiority of dose dense vs. 'standard' q3week chemo in patients receiving the same chemo agents - only the schedule differed - with an HR of 0.83 (p<.001) for any recurrence, but also significant improvements in breast cancer specific and all cause mortality....

We utilize the regimen scheduled studied in KEYNOTE-522 with q3 week AC. Having given carbo/taxol-ddAC prior to the use of pembrolizumab, I find that the tolerance of AC chemotherapy and count recovery has been better with q3week schedule. Although prior studies have shown improvement of outcomes with dose dense regimens, whether dose dense AC would improve outcomes in the context of this regimen is not clear and thus, we built our treatment protocol Beacon regimen to utilize the q3 week schedule studied in KEYNOTE-522.