American Surgical Association Annual Meeting
Search Meeting Site Only
 
Main ASA Website
Current Meeting Home
Final Program
Past & Future Meetings

 

 

Back to 2015 Annual Meeting Program


Impact Of The Addition Of Carboplatin And/or Bevacizumab To Neoadjuvant Paclictaxel Followed By Doxorubicin And Cyclophosphamide On Breast Conservation Rates In Triple-negative Breast Cancer: Surgical Results From CALGB 40603 (Alliance).
Mehra Golshan*1, Constance T. Cirrincione*2, Donald T. Berry*3, William M Sikov*4, Sara Jasinski*2, Tracy F. Weisberg*5, George Somlo*6, Eric P. Winer*7, Clifford Hudis*8, David W. Ollila9
1Brigham and Women's Hospital, Boston, MA;2Alliance Statistics and Data Center; Duke University, Durham, NC;3Alliance Statistics and Data Center, MD Anderson, Houston, TX;4Women and Infants Hospital, Providence, RI;5Maine Center for Cancer Medicine, Scarborough, ME;6City of Hope Medical Center, Los Angeles, CA;7Dana Farber Cancer Institute, Boston, MA;8Memorial Sloan-Kettering Cancer Center, New York, NY;9University of North Carolina, Chapel HIll, NC

Objective: Neoadjuvant chemotherapy (NACT) improves breast conserving therapy (BCT) rates, but the magnitude of this benefit in different tumor subtypes is unknown. To quantify this effect for triple-negative breast cancer (TNBC), we reviewed surgical outcomes from CALGB(40603), a randomized phase II trial of weekly paclitaxel (P) +/- carboplatin (Cb) followed by doxorubicin plus cyclophosphamide (AC), +/- bevacizumab (B).
Methods: Patients with stage II-III TNBC were randomized to (1) P->AC, (2) P+B->AC+B, (3) P+Cb->AC, or (4) P+Cb+B->AC+B. The surgeon assessed BCT candidacy based on clinico-radiographic criteria, before and after NACT, though subsequent surgical management was at surgeon and patient discretion. We recorded (1) the conversion rate from BCT-ineligible to BCS-eligible; (2) the rate of successful BCT.
Results: 406 of the 443 treated patients were assessable. Prior to NACT, 230 (57%) were considered BCT candidates and 176 (43%) were not. 190/230 (83%) remained BCT candidates after NACT; of 135 who chose BCT, it was successful in 126 (93%). 88/176 (50%) patients initially considered non-candidates were converted to candidates, of who 55 chose BCT with 49/44 (89%) success rate (Table 1). 278 patients who were BCT candidates post-NACT, 88 (32%) chose mastectomy.
Conclusions: This is the first NACT trial to prospectively quantify a 50%-conversion rate from BCT-ineligible to eligible in TNBC. Post-NACT: BCT was successful in 92% who chose this approach, however 32% of BCT-eligible patients chose mastectomy.


Back to 2015 Annual Meeting Program


© 2022 American Surgical Association. All Rights Reserved. Privacy Policy.