How would you treat an elderly female with residual TNBC following surgery and neoadjuvant carboplatin and paclitaxel?

Assume normal cardiac function and no obvious co-morbidities. No anthracycline previously due to age alone. The patient’s BRCA status is unknown, but presumably negative given her age. She has not received capecitabine yet at this time.

1 Answer

Mednet MemberInvited Expert

Medical Oncology · H Lee Moffitt Cancer Center, University of South Florida

Answered on · Updated on

I think there will be some differing opinions on this. There are a number of things I would factor in, assuming the patient has enough life expectancy where the breast cancer is the main mortality risk.

1) Data from carbo/taxane neoadjuvant trials (Sharma et al., PMID 30061361) and others suggest RCB1 patients do almost as well as PCR, so I would only consider more treatment if she has RCB2-3. However, their data didn't seem to show that giving adjuvant AC made a big difference in outcomes either.

2) Some data suggests the baseline clinical stage matters in non PCR cases with stage 2 cases doing better than stage 3. (Spring et al., PMID 28982747) So I would be less inclined to put her through AC if she had a smaller node negative tumor, to ...

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