Treatment with cisplatin in individuals with untreated triple-negative breast cancer (TNBC) demonstrated a higher response rate compared with carboplatin in the phase II TBCRC009 trial, says Kim Blackwell, MD. In this trial, the response rate was 32.6% with cisplatin versus 18.7% with carboplatin. This dramatic increase in response with cisplatin over carboplatin resulted in the reconsideration of carboplatin in this setting, notes Blackwell.

However, outside of efficacy, carboplatin may be better tolerated, suggests Richard Finn, MD. Toxicity and lifestyle are important considerations when determining the treatment of individuals with breast cancer whose disease progressed while on taxane therapy, agree Ruth O’Regan, MD, and Lee Schwartzberg, MD.

When considering toxicity advantages, Blackwell notes that eribulin may be superior to capecitabine as a treatment for patients with TNBC. This advantage was seen in data from patients with locally recurrent metastatic breast cancer following progression on a taxane and anthracycline treated with eribulin across 2 large open-label phase III trials. For patients with TNBC, the median OS was 12.9 months with eribulin compared with 8.2 months in the control (HR = 0.74; 95% CI, 0.60-0.92, P = .006). However, these findings need to be proven in a prospective trial.