Multicenter Real-world Evaluation of Neoadjuvant Carboplatin in Triple- negative Breast Cancer

Background The benefit of adding carboplatin to standard anthracycline–taxane neoadjuvant chemotherapy for triple-negative breast cancer (TNBC) remains debated, particularly in settings with limited access to immunotherapy. We evaluated the real-world impact of neoadjuvant carboplatin on pathological complete response (pCR) and survival outcomes.. Methods This retrospective, multicenter observational study included adult patients with nonmetastatic TNBC treated with neoadjuvant chemotherapy between January 2018 and December 2023 at three oncology centers in Turkey. Patients received anthracycline- and taxane-based regimens with or without carboplatin. The primary endpoint was pCR (ypT0/TisN0). Overall survival (OS) and disease-free survival (DFS) were estimated using Kaplan–Meier methods and compared with the log-rank test; Cox regression was used to identify independent prognostic factors. Results Among 142 patients, 45 (32.2%) received platinum-containing neoadjuvant therapy. Overall, pCR was achieved in 80 patients (56.3%). The pCR rate was higher with carboplatin than without (62.2% vs 42.1%, p  = 0.031). With a median follow-up of 57 months, 60-month OS was 96% in the platinum group versus 73.9% in the nonplatinum group ( p  = 0.027), while DFS differences were not statistically significant ( p  = 0.139). Conclusion In this multicenter real-world cohort, adding carboplatin to neoadjuvant chemotherapy was associated with higher pCR rates and improved OS. Achieving pCR and receipt of platinum remained independently associated with better survival in multivariable analyses.