Chemotherapy Before Surgery Can Benefit Advanced-Stage, Triple-Negative Breast Cancer

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A small, early study found that 66% of locally advanced, triple-negative breast cancers treated before surgery with a combination of carboplatin (brand name: Paraplatin) and Taxotere (chemical name: docetaxel) had no living cancer cells in the tumor when it was removed. Doctors use the term "pathologic complete response" when no cancer cells are found in a tumor after treatment. These results were presented at the 2010 American Society of Clinical Oncology (ASCO) Breast Cancer Symposium.

Locally advanced means the cancer has spread beyond the breast to nearby tissue such as the skin or the tissue of the chest wall.

Treatment given before surgery to weaken or shrink the cancer is called neoadjuvant treatment. Neoadjuvant treatment often is recommended when the breast cancer is large, aggressive, and/or has already spread beyond the breast to surrounding tissue.

Triple-negative breast cancer is:

  • estrogen-receptor-negative
  • progesterone-receptor-negative
  • HER2-negative

About 15% to 20% of breast cancers are triple-negative. Triple-negative cancers usually are more aggressive, harder to treat, and more likely to come back (recur) than cancers that are hormone-receptor-positive and/or HER2-positive. Hormonal therapy and the targeted therapies Herceptin (chemical name: trastuzumab) and Tykerb (chemical name: lapatinib) usually don't work on triple-negative breast cancer.

Because triple-negative breast cancer is aggressive and there are a limited number of treatment choices, doctors are looking for new ways to treat it. They are looking at new combinations of standard chemotherapy medicines and newer targeted therapies such as Avastin (chemical name: bevacizumab), as well as experimental medicines called PARP inhibitors.

In this study, 14 women diagnosed with locally advanced, triple-negative breast cancer were neoadjuvantly treated with a combination of two chemotherapy medicines: carboplatin and Taxotere. The women received six courses of the chemotherapy combination before surgery in three-week cycles. All of the women completed the entire chemotherapy course. After chemotherapy, the women had surgery to remove the breast cancer. A pathologist examined the removed tissue to see if there were signs of cancer cell activity.

Nine of the 14 women had a pathologic complete response to the chemotherapy given before surgery. This is notable because pathologic complete response to treatment usually indicates improved survival without the cancer growing.

Most of the women had side effects that were bothersome but expected with these chemotherapy medicines, including hair loss, mouth sores, low blood cell counts, intestinal upset, and pain in the hands and feet. None of the women had to stop getting chemotherapy because of side effects, although 11 women had at least one side effect that was considered severe.

The researchers are continuing to follow the women to track long-term results.

Based on these encouraging results, the researchers believe a larger study on this neoadjuvant chemotherapy combination to treat women diagnosed with triple-negative breast cancer should be done.

If you've been diagnosed with triple-negative breast cancer and are planning your treatment, you might want to talk to your doctor about this study. Ask your doctor if neoadjuvant therapy makes sense for you based on your unique situation.

You can learn more about carboplatin and Taxotere, including how they work and their possible side effects, in the Breastcancer.org Drugs for Treatment and Risk Reduction section.

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