Introduction Neoadjuvant chemotherapy (NAC) is the standard of care for locally advanced breast cancer. The achievement of pathological complete response (pCR) in response to NAC is of clinical significance as it correlates with improved long-term outcome. pCR rate varies with different chemotherapeutic agents and a higher rate may be associated with higher treatment cost and more toxicity.

Triple-negative breast cancer (TNBC) has poorer prognosis than non-TNBC (estrogen receptor, progesterone receptor, and/or human epidermal growth factor receptor 2 expressing tumors), but patients achieving pCR may have similar outcome. We evaluated the response of TNBC after taxane and nontaxane-based NAC and its correlation with survival outcome.

Materials and Methods This was a retrospective study comparing the efficacy of “taxotere, Adriamycin and cyclophosphamide TAC” versus “cyclophosphamide, epirubicin, 5-fluorouracil/cyclophosphamide, Adriamycin, 5-fluorouracil (CEF/CAF)” NAC regimens in patients with locally advanced TNBC. The efficacy and safety of both the regimens were compared. Overall and disease-free survival were analyzed.

Results Two-hundred and forty-nine eligible patients were included and divided into two groups: taxane group receiving “TAC” regimen (123 patients) and nontaxane group receiving “CEF/CAF” regimen (126 patients). A higher pCR rate was achieved with taxane compared with nontaxane NAC (28 vs. 12%) (p = 0.0001). Although taxane addition did not lead to survival advantage for the entire group, significantly better survival rates were achieved for patients who had pCR compared with similar subgroup of patients in nontaxane group. Both the NAC regimens were well tolerable.

Conclusion Taxane-based NAC was although costlier than anthracycline-based regimen but was more effective, resulting in a higher pCR rate and an improved survival outcome in patients who achieved pCR.

All authors contributed to the concept, design, and data acquisition and analysis, manuscript preparation, manuscript editing, and manuscript review

The manuscript has been read and approved by all the authors

Article published online:
22 June 2022

© 2022. Spring Hope Cancer Foundation & Young Oncologist Group of Asia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India