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TNT Study Phase III

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123Donna View Drop Down
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    Posted: Aug 09 2015 at 1:12am
TNT Study for Triple-Negative or BRCA1/2 Breast Cancer 

The phase III TNT trial randomized 376 patients with triple-negative breast cancer (TNBC) or BRCA1/2 mutation positive metastatic breast cancer to first-line treatment with docetaxel or carboplatin. In the full population, the results did not demonstrate a significant difference between the two agents, states Debu Tripathy, MD, although patients with BRCA1/2 mutations who received carboplatin achieved a greater response and longer progression-free survival compared with docetaxel. In those with BRCA1/2 breast cancer, the objective response rate (ORR) with carboplatin was 68.0% compared with 33.3% for docetaxel (P = .03). In this same population, carboplatin showed a 6.8-month progression-free survival compared with 4.8 months with docetaxel. However, patients with homologous recombination deficiency (HRD) experienced similar outcomes between the docetaxel and carboplatin arm. In the HRD high arm, the ORR with carboplatin was 38.2% versus 42.6% with docetaxel (P = .82).  The TNT data did not show that HRD, which is hypothesized to confer sensitivity to platinum agents, made a difference in terms of outcomes, notes Joyce O’Shaughnessy, MD. Earlier administration of the ACT regimen (doxorubicin and cyclophosphamide followed by docetaxel) in the adjuvant or neoadjuvant setting may have eliminated cells with HRD, resulting in a disease without HRD at the time of recurrence, O’Shaughnessy postulates. There aren’t enough data at present to use HRD testing to select patients for carboplatin treatment in TNBC, comments Edith Perez, MD. For the overall group of patients, physicians can use either docetaxel or carboplatin, adds Perez. - 


DX IDC TNBC 6/09 age 49, Stage 1,Grade 3, 1.5cm,0/5Nodes,KI-67 48%,BRCA-,6/09bi-mx, recon, T/C X4(9/09)
11/10 Recur IM node, Gem,Carb,Iniparib 12/10,MRI NED 2/11,IMRT Radsx40,CT NED11/13,MRI NED3/15

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123Donna View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote 123Donna Quote  Post ReplyReply Direct Link To This Post Posted: Jan 08 2018 at 8:09am
TNT trial: Results of a Phase III study of carboplatin versus docetaxel for patients with metastatic or recurrent locally advanced triple-negative or BRCA1/2 mutation-associated BC

DR LOVE: Could you just briefly summarize what the TNT study looked at?

DR ROBSON: So TNT study was — again, Andrew Tutt did the study over in the UK looking at patients with triple-negative breast cancer, randomizing to either get carboplatin or docetaxel as first-line therapy for metastatic disease. And the responses overall between the patients who got docetaxel and carboplatin were pretty similar in the triple-negative group as a whole. But in the group of patients who had germline BRCA mutations, relatively small preplanned subset, there was an advantage with the overall response rate, was 68% in the carbo arm and down in the 30s in the docetaxel arm. And there was also a difference in PFS. And all of those numbers were pretty similar to what we saw in OlympiAD.

http://www.researchtopractice.com/BCU117/Video/1?playlistIndex=0#t=25m10s

DX IDC TNBC 6/09 age 49, Stage 1,Grade 3, 1.5cm,0/5Nodes,KI-67 48%,BRCA-,6/09bi-mx, recon, T/C X4(9/09)
11/10 Recur IM node, Gem,Carb,Iniparib 12/10,MRI NED 2/11,IMRT Radsx40,CT NED11/13,MRI NED3/15

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Post Options Post Options   Thanks (0) Thanks(0)   Quote mainsailset Quote  Post ReplyReply Direct Link To This Post Posted: Jan 08 2018 at 10:58am
Goes back to what we all know and that is that the more knowledge doctors can glean about individual tumor characteristics and the role of DNA the better they can choose for successful therapies.
dx 7/08 TN 14x6.5x5.5 cm tumor

3 Lymph nodes involved, Taxol/Sunitab+AC, 5/09 dbl masectomy, path 2mm tumor removed, lymphs all clear, RAD 32 finished 9/11/09. 9/28 CT clear 10/18/10 CT clear
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