Would you consider avoidance of AC and proceeding to surgery in a cT2N0 TNBC patient who achieves a significant clinical response to carboplatin, paclitaxel, and pembrolizumab as part of the KEYNOTE-522 regimen?

Full disclosure -- I trained in breast cancer at UCLA, where we generally avoid anthracyclines. The main downside of adding an anthracycline to a taxane-based regimen is the elevated risk of leukemia, myelodysplasia, and congestive heart failure or weakening of the heart long-term.

I use neoadjuvant...