Neoadjuvant Regimens and Their Impact on Adjuvant T-DM1 Outcomes in HER2-Positive Early Breast Cancer
Makaleler > Tam Makale · 2025
Yazarlar: Ahmet Burak Agaoglu, Atike Pinar Erdogan, Ferhat Ekinci, Mustafa Sahbazlar, Guler Nur Tekustun, Ozgur Tanriverdi, Salih Tunbekici, Erdem GÖKER, Mehmet Sinan Akarca, Can Cangur, Taliha Guclu Kantar, Sedat Biter, Ertugrul Bayram, Gokhan Colak, Bilgin Demir, Hasan Basir, Vehbi Ercolak
Medicina, Uluslararası, Wos, 2025, cilt 61, ss 1966-1966
Özet
Background and Objectives: In early-stage HER2-positive breast cancer, ado-trastuzumab emtansine (T-DM1) has been adopted as the preferred adjuvant approach for patients left with residual invasive disease despite neoadjuvant therapy. The influence of different neoadjuvant regimens on subsequent outcomes in real-world settings remains uncertain. Materials and Methods: From 2019 to 2025, 102 patients treated with adjuvant T-DM1 following surgery after neoadjuvant chemotherapy were retrospectively assessed. Neoadjuvant regimens included doxorubicin plus cyclophosphamide followed by trastuzumab-paclitaxel, doxorubicin plus cyclophosphamide with pertuzumab–trastuzumab–docetaxel, or docetaxel–carboplatin–trastuzumab–pertuzumab. Clinical features, treatment response, survival, and toxicity were evaluated. Results: The mean age of the cohort was 49.7 years, and the majority of patients (80.4%) were aged 40 years or older. Hormone receptor positivity was 82.0%, and invasive ductal carcinoma accounted for 97.1% of cases. Regional responses included 39.2% with axillary pCR despite residual breast lesions, and 5.9% with breast pCR accompanied by axillary disease. Kaplan–Meier analysis demonstrated disease-free survival rates of 100%, 95.2%, and 92.2% at 1, 3, and 5 years, respectively. Adverse events were predominantly grade 1–2, while grade 3–4 toxicities occurred in under 5% of the cohort. Baseline characteristics varied across regimens, reflecting real-world treatment preferences, but survival outcomes remained comparable. Conclusions: Adjuvant T-DM1 was associated with high survival rates and manageable toxicity across different neoadjuvant regimens, underscoring its consistent benefit in routine clinical practice.