What adjuvant chemotherapy regimen do you recommend for a patient with T1cN0 TNBC?
If said patient was known to be gBRCA mutated, would you use neoadjuvant chemotherapy to enable adjuvant olaparib for those that did not have a pCR?
Answer from: Medical Oncologist at Community Practice
This is such a nuanced question that comes up with our fellows and affiliates a lot. I will give my take on this, although I want to acknowledge there are still pockets of uncertainty here!I want to start by saying that in the purely adjuvant setting, we have the ABC trials (USOR 06-090, NSABP-B46I/...
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Answer from: Medical Oncologist at Academic Institution
I disagree with Dr. @Charles L. Shapiro. For many years, my 'go-to' regimen for stage I TNBC was TC (docetaxel and cyclophosphamide) x 4, and results of the ABC analysis didn't change that - the benefit from the addition of doxorubicin in node negative TNBC was so small that it is, in my opinion, ou...
Answer from: Medical Oncologist at Academic Institution
My cut off for AC-Taxane in the adjuvant setting is typically stage IIA-III TNBC disease. Stage II-III disease is required for use of neoadjvuant KN522 and for adjuvant olaparib as well. The NCCN guidelines don't advocate for anthracycline over non-anthracycline regimens for T1cN0 disease although, ...
Answer from: Medical Oncologist at Academic Institution
If the tumor is 1.5 cm or greater, I would treat with neoadjuvant chemotherapy consisting of weekly paclitaxel and carboplatin with pembro followed every 3 week AC with pembro followed by adjuvant pembro as in the KEYNOTE 522 trial (Schmid et al., PMID 32101663). If less than 1.5 cm, I would use DD ...
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Medical Oncologist at Colorado Permanente Medical Group Hematology & Oncology
On KEYNOTE 522, patient had to be a T2, so 2.0 cm ...
On KEYNOTE 522, patient had to be a T2, so 2.0 cm ...