Dr Stearns on the Role of Carboplatin in Early-Stage TNBC

“The PEARLY study helps us as we move forward with this regimen, knowing that carboplatin added to anthracycline/taxane [regimens enhances] disease-free and overall survival benefit [for] patients with triple-negative breast cancer.”

Vered Stearns, MD, director, Translational Breast Cancer Research, Weill Cornell Medical School, discusses the role of carboplatin in early-stage triple-negative breast cancer (TNBC) according to results from the phase 3 PEARLY trial (NCT02441933).

In reference to her presentation at the 42nd Annual Chemotherapy Foundation Symposium (CFS) Symposium, Stearns explained that, despite being viewed as a standard of care and improving response rates when added to neoadjuvant therapy, the survival benefit with platinum-based chemotherapy agents in the early-stage setting remains inconclusive. She also noted that the precise role of carboplatin remains unclear.

The PEARLY study aimed to address this by evaluating whether carboplatin provides additional benefit when combined with anthracycline/taxane-based therapy vs anthracycline/taxanes alone as either neoadjuvant or adjuvant treatment in early-stage TNBC. After a median follow-up of 51.1 months, patients who received carboplatin in combination with the chemotherapy regimen had significantly improved event-free survival (EFS) compared with those who received standard chemotherapy alone (HR, 0.68; 95% CI, 0.50-0.93; P = 0.017). The 5-year EFS rate for the carboplatin arm was 81.9%, a 7.5% improvement over the control group’s rate of 74.4%.

A subgroup analysis revealed consistent benefits across various patient categories, further strengthening the evidence that carboplatin offers a survival advantage. Secondary end points, including invasive disease-free survival and distant recurrence-free survival, also favored the carboplatin-containing regimen.

The PEARLY study provides robust evidence that adding carboplatin to anthracycline and taxane-based therapy enhances survival benefits, positioning it as an effective treatment option for this patient population, Stearns summarizes. These findings reinforce the role of carboplatin in improving survival outcomes for patients with early-stage TNBC, she concludes.