We often encounter this scenario when we have residual disease after Neo-adjuvant chemotherapy in TNBC and I think about these 3 options :1) ECOG Trial/ NCT02445391: Phase III Trial randomizing Platinum ( 4 cycles of cisplatin or Carboplatin) Versus Oral Capecitabine x 6 cycles. (Requires residual d...

There are a couple of options for a patient who does not respond to neoadjuvant chemotherapy and has residual disease. The first would be to consider offering the patient to participate in SWOG 1418 that randomizes women to pembrolizumab vs. usual care. There is some evidence that immunotherapy may ...

If I'm treating off-study I would consider 8 cycles of capecitabine on the basis of the CREATE-X data. Treatment improved 5 year DFS by 8 percentage points with manageable toxicity. We need more time for OS data and reimbursement for early-stage disease.

While doing this would be very intriguing, currently there is no standard approved agents for sub-groups if triple negative breast cancer, unless clinical trials are considered.

Although it may be helpful to know the AR status, there is no standard treatment based on the additional subcategories outside of clinical trials. For someone who had minimal response to chemotherapy, I would explore adjuvant immunotherapy trials (some of which allows for concurrent radiation). The ...