“Perhaps in patients with BRCA 1 or 2 mutations, we’re getting close to thinking that platinum may be a standard, but even here I would await the completion of ongoing trials before we embrace that concept,” he said.
Among these studies is the 12-258 INFORM trial, a multicenter study in which 166 newly diagnosed breast cancer patients with BRCA1 or 2 mutations are being randomized to preoperative cisplatin or doxorubicin/cyclophosphamide.
Dr. William M. Sikov, principal investigator for the CALGB 40603 trial (J. Clin. Oncol. 2015;33:13-21), predicted there will be little crossover between the platinum-user and nonuser camps until definitive trials report whether the therapy improves relapse-free or overall survival.
“One group will say, ‘There’s an absolute increase in pathologic complete response with carboplatin in these two studies, and I’m convinced it’s a beneficial drug in these patients.’ It’s inexpensive, it’s available, although not approved for triple negative breast cancer, and it has some hematologic toxicities. But we have no long-term outcomes yet. I don’t think the TNT results will change anyone’s mind,” according to Dr. Sikov of Women and Infants Hospital in Providence, R.I.
Dr. Winer reported receiving research funding from Genentech. Dr. Sikov serves as a consultant to AbbVie and Celgene. Dr. Tutt reported having no financial conflicts.