Treatment Regimens and Response Rates in Early TNBC: A Review of Real-World Practice in the Second Decade of the 21st Century

Abstract

Background and Aims

Real-world evidence on the treatment of early triple-negative breast cancer (TNBC) remains limited. This study provides an overview of neoadjuvant chemotherapy (NACT) regimens used in the 2010s of the 21^st century, analyzing patient outcomes and treatment patterns based on real-world data from a large population-based cancer registry.

Methods

In this retrospective, noninterventional, single-center study, we analyzed data from TNBC patients diagnosed between January 1, 2010, and December 31, 2018, registered in the Tumor Centre Regensburg. Data included demographics, pathology, treatment regimen, recurrence, and survival, with follow-up extending to December 2023. Outcomes included pathologic complete response (pCR), overall survival (OS), and recurrence-free survival (RFS).

Results

A total of 319 patients were included. Among them, 132 patients (41.4%) received NACT with epirubicin/cyclophosphamide (EC) and paclitaxel (EC-T), 74 patients (23.2%) received NACT with EC-T and platinum (EC-P/T), and 22 patients (6.9%) received NACT with EC-P/nab-paclitaxel (EC-P/nabP). Other NACT protocols were administered in 91 (28.5%) patients. A pCR occurred in 49.8% of NACT patients, with a 37.1% rate in the subgroup without platinum. Addition of platinum significantly increased the pCR rate to 54.1% compared to EC-T (odds ratio [OR] 3.476, 95% confidence interval [CI] 1.655–7.300, p = 0.001). EC-P/nabP led to a significant increase in pCR rate to 77.3% (OR 8.767, 95% CI 2.421–31.744, p < 0.001).

Conclusion

The evidence from clinical trials was quickly incorporated into clinical practice, leading to higher pCR rates and benefits for patients. In the next step, the implementation of immune checkpoint inhibitors in real-world practice will be analyzed.