What adjuvant treatment would you recommend for a patient with node positive TNBC who did not receive neoadjuvant chemotherapy?

So much of our work has focused on making sure we deliver neoadjuvant therapy to patients with TNBC. However, sometimes patients don't follow rules. They may have a very small primary that is T1a or b and no obvious nodes and then surprise nodal disease, or the patient refuses chemotherapy initially...

Perhaps this is somewhat of a philosophical discussion, because there is really no absolutely correct answer at this point. We acknowledge that IO, as delivered in the KEYNOTE 522 study, showed improved outcomes in that population and setting, but was it the timing that was important? Is having an i...