Anthracycline-Free Neoadjuvant Therapy With Nab-Paclitaxel and Carboplatin in Non-Luminal Breast Cancer: A Single-Arm Clinical Trial.
Jiayi Wu, Deyue Liu, Mengdi Chen et al.
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In 30 seconds
NEOPATH was a prospective, single-centre, single-arm clinical trial evaluating neoadjuvant nab-paclitaxel plus carboplatin in patients with stage II–III triple-negative or HER2-positive breast cancer; HER2-positive patients also received trastuzumab and pertuzumab. Of 106 enrolled patients, 99 proceeded to surgery. The overall pathological complete response rate was 41.41%, with rates of 33.78% in triple-negative and 64.00% in HER2-positive disease. The regimen was anthracycline-free; the most frequent grade 3 or higher adverse event was neutropenia (57%).
Key findings
- Pathological complete response was 41.41% overall, 33.78% in triple-negative disease, and 64.00% in HER2-positive disease.
- Three-year event-free survival was 87.24% in the triple-negative group and 91.43% in the HER2-positive group.
- Objective response rates were 72.49% overall, 67.12% in triple-negative disease, and 88.00% in HER2-positive disease.
- Grade 3 or higher neutropenia occurred in 57%; vomiting in 11% and thrombocytopenia in 8%.
Why it matters
The trial provides prospective evidence on an anthracycline-free neoadjuvant option for stage II–III non-luminal breast cancer, with pathological response and three-year event-free survival reported separately by subtype. These outcomes may inform evaluation of regimens intended to avoid anthracyclines, while the observed severe neutropenia underscores the need to consider treatment toxicity.
What to keep in mind
The study was single-centre and single-arm, so it cannot establish comparative efficacy or safety against an alternative regimen.