A 38-year-old BRCA1 mutation carrier with a newly diagnosed ER-negative, HER2-negative (triple-negative) breast cancer is planned for neoadjuvant chemotherapy. Which addition to standard anthracycline-taxane regimen has demonstrated improved pathological complete response rates in BRCA-mutated tumors?
- A Capecitabine
- B Pertuzumab
- C Carboplatin ✓
- D Olaparib
Correct answer: C. Carboplatin
Explanation
Carboplatin exploits homologous recombination deficiency in BRCA1/2-mutated tumors — platinum agents cause interstrand DNA crosslinks that BRCA-deficient cells cannot repair, markedly increasing pathological complete response (pCR) rates in neoadjuvant trials (GeparSixto, INFORM). Capecitabine is used post-neoadjuvant for residual disease (CREATE-X trial). Pertuzumab is HER2-targeted. Olaparib is a PARP inhibitor used in the adjuvant setting post-neoadjuvant for residual disease (OlympiA trial), not added to neoadjuvant induction.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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