Management of Triple Negative Breast Cancers who Only Achieve a Partial Response to Neoadjuvant Chemotherapy

  • Patients with triple negative breast cancer who only achieve a partial response to neoadjuvant chemotherapy (have residual disease):
    • Failure to achieve pathologic complete response (pCR):
      • Is associated with poorer prognosis, particularly for triple negative breast cancer
  • In the CREATE-X trial:
    • 910 patients with HER2-negative residual invasive breast cancer after neoadjuvant chemotherapy:
      • Were randomized to receive standard post surgical treatment with capecitabine or control
    • Adjuvant capecitabine resulted in:
      • Improved disease-free survival and overall survival;
        • With the bulk of the benefit seen only in the patients with triple negative disease
    • Based on this study:
      • Adjuvant capecitabine can be considered for patients with triple negative breast cancer and residual disease after neoadjuvant chemotherapy
  • References
    • Cortazar P, Zhang L, Untch M, Mehta K, Costantino JP, Wolmark N, et al. Pathological complete response and long-term clinical benefit in breast cancer: the CTNeoBC pooled analysis. Lancet. 2014;384(9938):164-172.
    • Masuda N, Lee S-J, Ohtani S, Im YH, Lee ES, Yokota I, et al. Adjuvant Capecitabine for breast cancer after preoperative chemotherapy. New Engl J Med. 2017;376(22):2147-2159.

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