BACKGROUND: The KEYNOTE-522 trial established neoadjuvant chemoimmunotherapy as the standard of care for patients with stage II or III triple-negative breast cancer (TNBC) with a regimen of carboplatin and paclitaxel followed by doxorubicin plus cyclophosphamide (AC) with pembrolizumab given throughout. However, AC was administered every 3 weeks in the trial despite survival benefits demonstrated with the every-2-week dose-dense AC (ddAC) schedule in previous studies. Concerns of scheduling asynchrony are often raised by clinicians in combining every-2-week AC with every-3-week pembrolizumab.

OBJECTIVE: To characterize the utilization of a modified KEYNOTE-522 regimen containing ddAC for patients with TNBC at our institution.

METHODS: This retrospective cohort study included patients with breast cancer who received neoadjuvant AC concomitantly with pembrolizumab from October 1, 2021, to December 31, 2023, at Henry Ford Hospital. The primary end point was the incidence of neutropenia during AC treatment.