Lajos Pusztai, MD, DPhil, Professor of Medicine and Director of Breast Medical Oncology at Yale University, New Haven, Connecticut, who was the formal discussant of the papers by Sikov et al and Rugo et al, said there is mounting evidence for using carboplatin. He and his own research team have estimated that carboplatin plus chemotherapy may result in about a 15% reduction in the risk for recurrence, but he also predicted, “this may not reach statistical significance in the CALGB 40603 trial,” largely attributed to the limited statistical power due to modest sample size.

“This provides a valid new treatment option for patients with high-risk triple-negative disease,” Dr. Pusztai concluded. “The impact on survival may be modest, but I believe it will be observable with longer follow-up.” He also pointed out that more effective neoadjuvant chemotherapy also provides patient-level benefits other than survival, including smaller surgery, better cosmesis, additional prognostic information, and an opportunity to seek out further adjuvant therapies (on clinical trials) in case of extensive residual cancer.” ■

Disclosure: Dr. Pusztai reported no potential conflicts of interest.