Introduction:

The window of opportunity design, which includes administering systemic therapy for a brief period of time between diagnosis of cancer and surgery, has sparked a lot of attention in recent years as a way to assess chemosensitivity in cancer patients prior to definitive treatment. Triple-negative breast cancer (TNBC) is an aggressive tumor subtype with inferior survival. There are limited and unreliable established biomarkers that have been identified before chemotherapy to diagnose patients likely to achieve pathological complete response (pCR).

Objectives:

To study the association of prognostic biomarkers with pCR in patients with non-metastatic TNBC following single-dose paclitaxel and carboplatin during the window period before neoadjuvant chemotherapy (NACT) followed by developing a composite predictive score using above parameters for the assessment of pCR in TNBC before NACT.

Methods:

The non-metastatic triple-negative breast cancer patients will be screened as per the inclusion-exclusion criteria. A baseline biopsy will be done for the assessment of biomarkers prior to intervention followed by a PET scan to study the change in SUV of the tumor. Patients will then receive paclitaxel and carboplatin during the window of opportunity period. The additional biopsy will be done after the intervention to assess the biomarker change followed by an additional PET scan. The post-surgery pathological response will be studied.

Discussion:

There is now fascinating evidence in cancer research; preoperative treatment with chemotherapy during the window period gives substantial prognostic information, which further helps in deciding treatment options. Changes in biomarkers during the short time period and their association with pathological complete response can act as surrogate markers of long-term survival outcomes.