Choosing Chemotherapy in Triple-Negative Breast Cancer Based on Homologous Recombination Deficiency

Triple-negative breast cancer (TNBC) continues to be a therapeutic challenge. Cancers with deficiencies in homologous recombination, such as tumors with BRCA1/2 somatic mutations, have been shown in preclinical studies to have greater sensitivity to platinum agents. Homologous recombination deficiency (HRD) status could potentially be used to help make treatment choices; however, results from clinical experience have been inconsistent and controversial.

In a phase 2 study, 147 patients with TNBC and wild-type BRCA1/2 were randomized to preoperative cisplatin (75 mg/m², every 3 weeks for 4 weeks) or paclitaxel (80 mg/m², weekly for 12 weeks). The study's primary goal was to assess the ability of HRD status to predict response to the assigned …