Dose dense doxorubicin plus cyclophosphamide in a modified KEYNOTE522 regimen for triple negative breast cancer Journal Article

   


Authors: Mai, N.; Myers, S.; Shen, S.; Downs-Canner, S.; Robson, M.; Norton, L.; Chen, Y.; Traina, T.; Abuhadra, N.
Article Title: Dose dense doxorubicin plus cyclophosphamide in a modified KEYNOTE522 regimen for triple negative breast cancer
Abstract: The KEYNOTE-522 (KN522) regimen for neoadjuvant treatment of triple negative breast cancer (TNBC) utilized q3week dosing for doxorubicin plus cyclophosphamide (AC); however, dose-dense AC (ddAC) has demonstrated superior overall survival (OS) compared to q3week AC in anthracycline and taxane-based regimens. We performed a retrospective analysis assessing the use of ddAC in KN522 and the impact of sequencing ddAC before or after carboplatin/paclitaxel (CbT) plus pembrolizumab on multiple outcomes. 128 patients with TNBC were included. Overall pathologic complete response (pCR) rate of 56%. Sequencing of ddAC vs CbT first showed no difference in pCR rate (ddAC 55% vs. CbT 58%, p = 0.77). However, ddAC first compared to CbT first correlated with a significant increase in the incidence of overall treatment delays (ddAC 70% vs. CbT 51%, p = 0.03), with cytopenias most frequent (ddAC 59% vs. CbT 31%, p = 0.001). ddAC in a modified KN522 regimen is safe, tolerable, and effective. Efficacy is comparable regardless of chemotherapy sequencing, but ddAC first is significantly associated with higher rates of treatment delays and cytopenias. © The Author(s) 2024.
Keywords: adult; cancer chemotherapy; human tissue; aged; major clinical study; overall survival; doxorubicin; paclitaxel; cancer staging; carboplatin; lung disease; cyclophosphamide; pathology; retrospective study; cardiovascular disease; liver disease; neoadjuvant chemotherapy; taxane derivative; anthracycline; autoimmune disease; cytopenia; chronic kidney failure; venous thromboembolism; pathological complete response; triple negative breast cancer; germline mutation; dose densification; very elderly; human; female; article; pembrolizumab; ecog performance status
Journal Title: npj Breast Cancer
Volume: 10
ISSN: 2374-4677
Publisher: Nature Publishing Group  
Date Published: 2024-06-04
Start Page: 39
Language: English
DOI: 10.1038/s41523-024-00643-5
PROVIDER: scopus
PMCID: PMC11150442
PUBMED: 38834621
DOI/URL:

https://www.scopus.com/inward/record.uri?eid=2-s2.0-85195427299&doi=10.1038%2fs41523-024-00643-5&partnerID=40&md5=25e894979774c2b64b1cdb5322dd09eb
Notes: Article -- Source: Scopus
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MSK Authors
  1. Larry Norton
    758 Norton
  2. Mark E Robson
    676 Robson
  3. Tiffany A Traina
    250 Traina
  4. Stephanie Michelle Downs-Canner
    37 Downs-Canner
  5. Sherry Shen
    22 Shen
  6. Nour Abuhadra
    23 Abuhadra
  7. Yuan Chen
    38 Chen
  8. Sara Poorfarahani Myers
    18 Myers
  9. Nicholas Mai
    7 Mai
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