Tata Memorial Cancer Hospital has showcased a trial that indicates better outcomes in the treatment of an aggressive subtype of breast cancer, through the use of a less expensive drug called carboplatin.

The results of the advanced Phase III study showed the commonly available and inexpensive drug, carboplatin, “increased the cure rate and survival of a very aggressive type of breast cancer, called triple-negative breast cancer (TNBC), especially among young women who have this disease,” Tata Memorial Centre (Mumbai) said, of the study done by its Breast Cancer Working Group. TMC Director, Dr Rajendra A Badwe, is the Principal Investigator of the study that has also been presented at the San Antonio Breast Cancer Symposium by Dr Sudeep Gupta, Professor of Medical Oncology at TMC.

The carboplatin intervention is made along with the conventional chemotherapy given to treat this subtype of breast cancer (Stage I to III), before surgery, said Shalaka Joshi, breast surgeon at the hospital, and part of the study team. The study found, it prevented one in four deaths, reduced recurrence and showed a high chance of the tumor being completely out, she added.

The drug costs around ₹1,000 per injection, and can be given across eight chemotherapy cycles, Dr Joshi told businessline, adding, it was a relatively small price to pay compared to immunotherapy drugs that are given, whose price runs into lakhs of rupees.

The findings are significant to India and developing countries, she said, where breast cancer is prevalent in young women. TNBC constitutes about 30 percent of breast cancer in India and about 45 percent of breast cancer in women younger than 50 years. The carboplatin intervention needs to become part of treatment protocol, she said, as the study has established its improved outcome.

Trial details

The randomised controlled trial enrolled women with the aggressive subtype (stage II-III), from 2010 to 2020. They were divided into two groups, both of whom received chemotherapy prior to surgery.

Women in the standard treatment group received standard chemotherapy comprising once per week paclitaxel for 8 weeks, followed by doxorubicin plus cyclophosphamide every 3 weeks for 4 cycles, TMC said. In the platinum group, women received the same chemotherapy with the addition of the carboplatin injection once a week for 8 weeks, given with paclitaxel.

Women in both groups underwent surgery after the last cycle of chemotherapy followed by radiotherapy. They were followed up once every six months.

Explaining the findings, Dr Badwe said, “In the whole study population cure rate (5-year disease-free survival) increased by 6.6 percent from 64.1 percent in the standard arm to 70.7 percent in the platinum arm and the overall survival increased by 7.6 percent from 66.8 percent in the standard arm to 74.4 percent in the platinum arm, which was statistically significant. Second, when the results were analysed by age, the benefit of weekly carboplatin was almost exclusively confined to women younger than 50 years”

“Third, platinum-based chemotherapy wiped the tumor clean as assessed by pathologists in the operated breast specimen (pathological complete response) in 61 percent of younger patients ...Fourth, carboplatin-based chemotherapy was well tolerated without high rate of toxicity.”