A 45-year-old woman with triple-negative breast cancer (TNBC) undergoing neoadjuvant chemotherapy is found to have BRCA1 germline mutation. Which agent, added to carboplatin-based neoadjuvant regimen, has shown benefit in the GeparSixto trial for TNBC?
- A Carboplatin ✓
- B Bevacizumab
- C Olaparib
- D Pembrolizumab
Correct answer: A. Carboplatin
Explanation
The GeparSixto trial demonstrated that adding carboplatin to standard neoadjuvant chemotherapy in TNBC significantly increased pathological complete response (pCR) rates, particularly in BRCA-mutant tumors. Bevacizumab added to neoadjuvant therapy (GeparQuinto) improved pCR but with no OS benefit. Olaparib is used in adjuvant setting post-neoadjuvant for BRCA-mutant HER2- high-risk patients. Pembrolizumab (KEYNOTE-522) added to chemotherapy also improves pCR in TNBC but is a separate trial.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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