Mumbai: Tata Memorial Centre (TMC) claims to have come up with a low-cost drug that reduces by 40 per cent the death rates among young women suffering from triple negative breast cancer (TNBC), which is very aggressive.
“This drug is more effective if given to a patient below 50 years of age. Moreover, four of 10 patients suffering from TNBC will survive after adding carboplatin drugs in the treatment. Meanwhile, two-thirds of patients have shown response and there is no resultant tumour and we don’t need to remove the whole breast,” said Dr Rajendra A Badwe, director TMC.
The results of the landmark ‘TMC Study – Platinum in TNBC’ was presented by Dr Sudeep Gupta, Professor of Medical Oncology at TMC, at the ongoing San Antonio Breast Cancer Symposium. TMC said it had conducted a phase III randomized controlled trial on 700 patients for from 2010 to 2020.
Doctors said the addition of carboplatin, a drug that costs Rs1,000 a month had shown good results in women below 50 years of age suffering from triple negative breast cancer. Dr Badwe was the principal investigator of the study, which was conducted by the Breast Cancer Working Group of TMC.
The study was a randomized controlled trial that enrolled women with stage II-III TNBC from 2010 to 2020. The women were divided into two groups, both of whom received chemotherapy to downstage the disease prior to surgery.
Women in the standard treatment group received standard chemotherapy consisting of once per week paclitaxel for eight weeks followed by doxorubicin plus cyclophosphamide every three weeks for four cycles.
In the platinum group, women received the same chemotherapy with the addition of injection carboplatin once every week for eight weeks, given with paclitaxel. Women in both groups underwent surgery after the last cycle of chemotherapy followed by radiotherapy. A follow up was done once every six months.
“The results of the study showed that a commonly available and inexpensive drug, carboplatin, increased the cure rate and survival of people suffering from a very aggressive type of breast cancer, called triple-negative breast cancer, especially among young women,” said Dr Badwe.
Statistics of TNBC diagnosis
One lakh people suffer from breast cancer, of which 30,000 are diagnosed with TNBC. Every year 10,000 women lose their life because of TNBC. The cure rate (5-year disease-free survival) increased by 6.6% from 64.1% in the standard group to 70.7% in the platinum group, Dr Badwe said.
The overall survival rate increased by 7.6% from 66.8% in the standard group to 74.4% in the platinum group, he said. When the results were analysed by age, the benefit of weekly carboplatin was almost exclusively confined to women younger than 50 years who had a large 12.5% increase in cure rate from 61.7% to 74.2% and an 11.2% gain in overall survival (5-year overall survival) from 65.9% to 77.1%, Dr Badwe said.
Third, platinum-based chemotherapy wiped the tumour clean as assessed by pathologists in the operated breast specimen in 61% of patients less than 50 years old, compared with 41% by standard chemotherapy. Carboplatin-based chemotherapy was well tolerated without a high rate of toxicity, he said.
“A commonly available and inexpensive treatment like carboplatin will now be routinely offered as part of pre-operative chemotherapy regimen to women with TNBC, which is the most aggressive type of breast cancer. Given that TNBC accounts for about 30% of breast cancer cases in India and about 45% of breast cancer in women younger than 50 years, the implications of this result are very important,” Dr Badwe said.
