E-poster Presentation 2014 World Cancer Congress

Abrupt Isolated central nervous system relapses after completion of palliative platinum based chemotherapy (#922)

vinayak v maka 1
  1. medical oncology, Gujarat cancer and research center, Ahmedabad, Gujarat, India

Background: Experimental data suggest that triple-negative breast cancer (TNBC) may have increased sensitivity to platinum-based chemotherapy but there is lack of relevant clinical data.  One of the characteristics of triple-negative breast cancer is their high chemo sensitivity with an early relapse and short progression free survival.

Aim:In this prospective study, Clinical outcomes in patients with metastatic TNBC treated with Platinum-based chemotherapy were evaluated .

Methods:21 selected patients with metastatic TNBC presenting at GCRI during the study period from 1st August 2009 to 31st October 2011, formed the study group with median follow up period of 10 months. They were given palliative chemotherapy based upon prior adjuvant chemotherapy along with an additional platinum compound. Response rates, relapse pattern and toxicities of platinum-based chemotherapy were recorded and analyzed.

Results: In evaluable TNBC patients, overall response rate and complete clinical response were 72 % and 38% with median response duration of four months. Response could not be assessed in three patients due to patient refusal for evaluation, lost to follow up and toxicities.  Haematological adverse effects were febrile neutropenia in 19% of patients, and grade 3–4 neutropenia (9%) thrombocytopenia and anaemia (7 %). The main non haematological adverse effects reported in the present study are peripheral neuropathy (14%) and severe emesis (9%). In three TNBC patients (14%) after completion of platinum based chemotherapy had early isolated CNS relapse with systemic disease in remission.

Conclusions: In our TNBC patients, platinum based chemotherapy had better overall response rates, higher complete clinical response rates, and acceptable safety profile. In patients on platinum based chemotherapy having complete response usually has isolated CNS failure which may be further studied for need for CNS consolidation like small cell carcinoma of lung .

  1. F. Heitz,J. Rochon, P. Harter,et al.Cerebral metastases in metastatic breast cancer: disease-specific risk factors and survival. Ann Oncol (2011) 22 (7): 1571-1581 first published online November 8, 2010 doi:10.1093/annonc/mdq625