Evidence map›Paper›PMID 38771399›Full record

ArticleBreast cancer research and treatment2024

Assessment of efficacy and safety of dose-dense doxorubicin and cyclophosphamide (ddAC) in combination with immunotherapy in early-stage triple-negative breast cancer.

Olivia White, Susan Dent, Kelly Westbrook, Hui-Jie Lee, Chengxin Yang, Heather N Moore

Abstract read
In one paragraph

Article in Breast cancer research and treatment, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Olivia WhiteDepartment of Pharmacy, University of Virginia Health System, Charlottesville, VA, USA. olivia.white@virginia.edu.ORCID http://orcid.org/0009-0001-5007-6586
Susan DentDuke Cancer Institute, Durham, NC, USA.ORCID http://orcid.org/0000-0002-9183-9340
Kelly WestbrookDuke Cancer Institute, Durham, NC, USA.ORCID http://orcid.org/0000-0001-9640-1076
Hui-Jie LeeDepartment of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA.ORCID http://orcid.org/0000-0002-6060-8443
Chengxin YangDepartment of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA.
Heather N MooreDuke Cancer Institute, Durham, NC, USA.ORCID http://orcid.org/0000-0002-0619-3267

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThis study aimed to assess safety and efficacy of a modified KEYNOTE 522 protocol, which incorporated pembrolizumab every 6 weeks, allowing for concomitant dose-dense (14 day) doxorubicin and cyclophosphamide (ddAC). By optimizing this dosing, the intention of this modified protocol was to improve pathologic complete response (pCR) rates in a population associated with a poorer prognosis.

methodsThis was a retrospective, single-center, cohort study. Patients were included if they had early stage, triple-negative breast cancer, and received at least one dose of AC. The entire cohort received neoadjuvant chemotherapy including weekly carboplatin and paclitaxel with pembrolizumab every 3 weeks for 12 weeks (4 cycles). The group then received either ddAC with pembrolizumab 400 mg every 6 weeks, or AC with pembrolizumab 200 mg every 3 weeks. The primary objective was pCR rate at time of surgery.

resultsThis study assessed outcomes in 25 patients over 34 months. The pCR rate in the pembrolizumab, AC 3-week cohort was 64.3% versus 81.8% in the ddAC and 6-week pembrolizumab group. No pembrolizumab-associated grade 3-4 adverse events occurred in the either cohort. Despite seeing an increased incidence of grade 3-4 toxicities in the ddAC arm, this did not result in additional chemotherapy delays or dose reductions.

conclusionThis study demonstrated tolerability and a potential for favorable outcomes with this patient population, making this modified KEYNOTE 522 protocol a reasonable treatment approach. Larger, prospective studies are warranted to assess the feasibility of this dosing and true optimization of patient outcomes given the small sample size of this study.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsCyclophosphamideDoxorubicinNeoadjuvant TherapyTriple Negative Breast NeoplasmsAdultAgedAntibodies, Monoclonal, HumanizedFemaleHumansImmunotherapyMiddle AgedNeoplasm StagingRetrospective StudiesTreatment OutcomeAntibodies, Monoclonal, HumanizedCyclophosphamideDoxorubicinpembrolizumabDose-densePembrolizumab dosingTriple-negative breast cancer

Identifiers

PMID38771399
PMCPMC11230943

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.