Up in flames.

Neoadjuvant therapy is the name of the game in inflammatory breast cancer (IBC). Treatment success heavily depends on the response to neoadjuvant therapy, so much so that  radiation is sometimes included for those with a poor response to neoadjuvant chemo. Despite all this, only about 15% of patients achieve a pathologic complete response (pCR). In this phase 1 trial, women with HER2-negative IBC received neoadjuvant chemotherapy consisting of carboplatin, nab-paclitaxel, and panitumumab (PNC) x 4 followed by good ole’ epirubicin, cyclophosphamide and 5FU (ECF) x 4. Side note: the rationale for including panitumumab (an EGFR monoclonal antibody) is that up to 50% of IBC over-express EGFR. Despite significant heme toxicity with PNC requiring dose adjustments, nearly 30% of patients achieved a pCR, primarily seen in those with triple negative tumors (42% versus 14% with hormone receptor-positive ones). TBL: Panitumumab as part of cytotoxic neoadjuvant chemo doubles the historic rate of pCR in women with inflammatory breast cancer. | Matsuda, JAMA Onc 2018