How would you approach treatment for a postmenopausal patient who was treated more than 5 years ago with AC-T for TNBC, and who now presents with ipsilateral, locally advanced, node-positive TNBC, but has severe residual neuropathy from prior taxane exposure?

Standard neoadjuvant chemotherapy for TNBC would have been anthracycline- and taxane-based regimens, with the addition of platinum agents (carboplatin or cisplatin) in high-risk cases to improve pathologic complete response (pCR) rates. However, in this case, further taxane use (including docetaxel) is not possible due to existing neurotoxicity, and anthracycline use would be limited by the concern of cumulative anthracycline cardiac toxicity in an older patient or in a patient with prior anthracycline exposure.

Alternative chemotherapy options for this patient include platinum-based regimens. Carboplatin and cisplatin have demonstrated efficacy in TNBC, particularly in tumors with DNA repair deficiencies, and can be considered as part of ne...