Systemic treatment strategies for triple-negative breast cancer

Table 1 Pathological complete response to triple-negative breast cancer in triple-negative breast cancer and non-triple-negative breast cancer patients

Ref.	Yr	No.	Therapy	PCR (%)
				TNBC	Non-TNBC
Liedtke et al[3]	2008	255	FAC → P	22	11
Chappuis et al[4]	2002	9	FEC 3 wk × 3-4	44	4
Skrypnikova et al[10]	2011	15	ACC	29.4	NR
Rouzier et al[11]	2005	82	P → FAC	45	6

FAC: 5-Fluorouracil, doxorubicin, cyclophosphamide; ACC: Doxorubicin, cyclophosphamide, capecitabine; P: Paclitaxel; PCR: Pathological complete response; TNBC: Triple-negative breast cancer; FEC: 5-Fluorouracil, epirubicin, cyclophosphamide.

Table 2 Chemotherapy regimen with their outcomes in triple-negative breast cancer

Ref.	Yr	No.	Therapy	Outcome
Martin et al[12]	2010	171	FEC FEC + P	7 yr DFS 56% vs 74%
Byrski et al[23]	2009	25	Cisplatin + P + GSF	5 yr DFS-76% DDFS-84%
Koshy et al[32]	2010	17	Cisplatin + gemcitabine	PFS-5.3 mo TNBC vs 1.7 mo non-TNBC
Maisano et al[31]	2011	31	Carboplatin + gemcitabine	ORR-32% PFS-5.5 mo

Anthracyclin and taxane pretreated TNBC patients. GSF: Granulocyte stimulating factor; ORR: Overall response rate; PFS: Progression free survival; DFS: Disease free survival; DDFS: Distant disease free survival; TNBC: Triple-negative breast cancer; P: Paclitaxel; FEC: 5-Fluorouracil, epirubicin, cyclophosphamide.

Table 3 Response to neoadjuvant platinum based chemotherapy trials in triple-negative breast cancer

Ref.	Yr	No.	Regimen	PCR
Garber et al[20]	2006	28	Cisplatin	21%
Silver et al[21]	2010	28	Cisplatin 3 wk × 4	22%
Byrski et al[22]		12	Cisplatin	83%
2Byrski et al[23]	2009	25	Cisplatin + paclitaxel + GSF	72%
Ryan et al[24]	2009	51	Cisplatin + bevacizumab 3 wk × 4	72%
Frasci et al[25]	2009	74	Cisplatin + epirubicin + paclitaxel wk × 8	65%
Sirohi et al[26]	2008	62	Platinum1 + epirubicin + 5-FU (infusion)	88% (cCR)
Sikov et al[27]	2007	10	Carboplatin 3 wk × 4 + paclitaxel wk × 16	50%
Leone et al[28]	2009	125	Platinum1 + docetaxel 3 wk × 4	29%
			Platinum + docetaxel → AC 3 wk × 4	40%

¹Cisplatin or carboplatin;

²In BRCA1 mutation carriers. AC: Doxorubicin + cyclophosphamide; 5-FU: 5-Fluorouracil; PCR: Pathological complete response; cCR: Clinical complete response; GSF: Granulocyte stimulating factor.

Table 4 Clinical outcomes with targeted therapy in metastatic triple-negative breast cancer

Ref.	Line of treatment	Regimen	No.	ORR (%)	CBR (%)	PFS (mo)	OS (mo)
O’Shaughnessy et al[40]	First line	Gemcitabine +	61	52	56	5.9	12
		Carboplatin ±	62	32	34	3.6	7.7
		Inipari2
Isakoff et al[42]	First line	Veliparib2 + TMZO	41	37.5	62.5	5.5	NR
Carey et al[44]	First line	Cetuxim12±	71	18	31	22	12
		Carboplatin1	54	6	10
O’Shaughnessy et al[45]	First or second line	Irinotecan +	52	49	NR	5.1	15.5
		Carboplatin ±
		Cetuxim12	51	30		4.7	12.3
Finn et al[49]	First line	Dasatini2	44	4.6	9.2	8.3 wk	NR
Baselga et al[46]	First or second line	Cisplatin ±	115	20	NR	3.73	12.9
		Cetuxim12	58	10		1.5	9.4
Gray et al[50]	First line	Paclitaxel ±	122	48	NR	11.83	NR
(E2100)		Bevacizum12	111	22		5.9
Miles et al[51]	First line	Docetaxel ±	58	64	NR	103	NR
(AVADO)		Bevacizum12	53	46		8
Robert et al[52]	First line	Tax/Anthr1	96	NR	NR	6.5	NR
(RiBBON-1)		± Bevacizum12	46			6.2
		Cap ±	87	NR	NR	6.13	NR
		Bevacizum12	50			4.2
Brufsky et al[53]	Second line	Cap, tax, gem/vinorel, ±	112	413	NR	6.03	17.9
(RiBBON-2)		Bevacizum12	47	18		2.7	12.6

¹Cross over to cetuximab + carboplatin arm after progressive disease;

²For entire cohort;

³Significant. TMZO: Temozolamide; ORR: Overall response rate; CBR: Clinical benefit rate; PFS: Progression free survival; NR: Not reported; Tax: Taxanes; Cap: Capecitabine; Gem: gemcitabine.