Cisplatine Subtypes And Breast Cancer - 1373 Words

)Platinum agents Platinum salts, including carboplatin and cisplatin, lead to DNA cross-link strand breaks, which may be especially important in cells that are deficient in homologous recombination repair mechanisms such as BRCA-mutated cells and TNBC. Leong and colleagues (Leong, et al. 2007).reported a p63-dependent tumor survival pathway that mediates cisplatin sensitivity, specifically in TNBC cells grown in vitro. Extending this observation to the clinical setting, Rocca and colleagues (Andrea, et al.2008).conducted a retrospective analysis of core biopsies of patients with breast cancer treated with neoadjuvant cisplatin-based chemotherapy in breast cancer and showed that administration of cisplatin without anthracyclines yielded a†¦show more content†¦CALGB40603 (NCT00861705) is a randomized phase II trial with a 2 Ãâ€" 2 factorial design that explored the addition of carboplatin  ± bevacizumab to neoadjuvant weekly paclitaxel followed by dose-dense AC in 443 patients with stage II /III TNBC (Sikov, et al. 2014) The pCR rate improved from 41% to 54% with the addition of carboplatin; bevacizumab had no added benefit. It is important to note that neither of these studies was powered to detect disease-free or overall survival (OS) benefit.( Ingrid et al.,2014) B) Capecitabine Several ongoing trials are addressing the intensification of adjuvant chemotherapy in TNBC patients, either through integration of novel agents into the adjuvant setting such as platinum, X, ixabepilone, or bevacizumab, or through introduction of maintenance therapy such as X (CIBOMA and SYSUCC-001) or bevacizumab (BEATRICE). Preliminary results of the CREATE-X (JBCRG-04) trial by the Japan Breast Cancer Research Group were presented at the 2015 San Antonio Breast Cancer Symposium (Toi, , et al.2016). The trial randomized 910 patients to observation versus 8 cycles of X therapy, and reported improved rates of 2-year DFS (87.3 vs. 80.5%; p = 0.001) and OS (96.2 vs. 93.9%; p = 0.086) with X. All of the observed benefit was driven by the improved outcome in the ER-