Breast最新文献

{"title":"Reevaluating prognostic differences in HR+/HER2− Breast Cancer: The unaccounted impact of CDK4/6 inhibitors","authors":"Arif Hakan Önder","doi":"10.1016/j.breast.2025.104462","DOIUrl":"10.1016/j.breast.2025.104462","url":null,"abstract":"","PeriodicalId":9093,"journal":{"name":"Breast","volume":"81 ","pages":"Article 104462"},"PeriodicalIF":5.7,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Towards precision therapy in HER2-positive early-stage breast cancer","authors":"Serena Di Cosimo , Paolo Verderio","doi":"10.1016/j.breast.2025.104461","DOIUrl":"10.1016/j.breast.2025.104461","url":null,"abstract":"","PeriodicalId":9093,"journal":{"name":"Breast","volume":"81 ","pages":"Article 104461"},"PeriodicalIF":5.7,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world utilization of aromatase inhibitors, tamoxifen, and ovarian function suppression in premenopausal patients with early hormone receptor-positive, HER2-negative breast cancer with increased recurrence risk","authors":"Volkmar Müller ,&nbsp;Manuel Hörner ,&nbsp;Marc Thill ,&nbsp;Maggie Banys-Paluchowski ,&nbsp;Sabine Schmatloch ,&nbsp;Peter A. Fasching ,&nbsp;Nadia Harbeck ,&nbsp;Dagmar Langanke ,&nbsp;Sabrina Uhrig ,&nbsp;Lothar Häberle ,&nbsp;Dorothea Fischer ,&nbsp;Alexander Hein ,&nbsp;Tanja N. Fehm ,&nbsp;Chloë Goossens ,&nbsp;Jürgen Terhaag ,&nbsp;Uwe Heilenkötter ,&nbsp;Peter Dall ,&nbsp;Christian Rudlowski ,&nbsp;Rachel Wuerstlein ,&nbsp;Mustafa Aydogdu ,&nbsp;Andreas D. Hartkopf","doi":"10.1016/j.breast.2025.104458","DOIUrl":"10.1016/j.breast.2025.104458","url":null,"abstract":"<div><h3>Background</h3><div>The optimal adjuvant endocrine treatment in premenopausal patients with hormone receptor-positive, HER2-negative (HRpos/HER2neg) early breast cancer (eBC) remains debated, particularly the choice between aromatase inhibitors plus ovarian function suppression (AI + OFS) or tamoxifen (TAM) with or without additional OFS. This study assessed the use of adjuvant endocrine therapies for premenopausal patients with intermediate/high-risk HRpos/HER2neg eBC.</div></div><div><h3>Methods</h3><div>CLEAR-B (AGO-B-059; NCT05870813) was a retrospective study analyzing data, collected from January 2016 to June 2019 and from January 2022 to December 2023 during the certification process of breast centers in Germany. Premenopausal patients with HRpos/HER2neg intermediate/high-risk eBC were eligible. Patient and disease characteristics, in addition to recommended and received adjuvant treatments, were evaluated.</div></div><div><h3>Results</h3><div>The number of registered patients was 3137, of whom 2789 had complete information on endocrine treatments (1717 for 2016–2019 and 1072 for 2022–2023). In 2016–2019, 8.4 % of the patients were recommended to be treated with AI + OFS, whereas in 2022–2023, the proportion of patients with a treatment recommendation for AI + OFS rose to 42.1 %. In 2016–2019, TAM monotherapy was most frequently recommended (80.8 %). Conversely, TAM + OFS was not commonly recommended (9.3 % in 2016–2019 and 16.5 % in 2022–2023). While no clear association between tumor stage and chosen endocrine therapy was found in 2016–2019, most patients with ≥stage IIA were recommended to be treated with AI + OFS in 2022–2023.</div></div><div><h3>Conclusion</h3><div>This analysis shows that treatment recommendation for AI + OFS in premenopausal patients with HRpos/HER2neg eBC increased relevantly in the past years, reflecting latest guideline recommendations.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"81 ","pages":"Article 104458"},"PeriodicalIF":5.7,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143704593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term outcomes of three distinct once-daily schedules for accelerated partial breast irradiation","authors":"Lorenzo Vinante ,&nbsp;Michele Avanzo ,&nbsp;Angela Caroli ,&nbsp;Carlo Furlan ,&nbsp;Andrea Sacilotto ,&nbsp;Lorena Baboci ,&nbsp;Tiziana Perin ,&nbsp;Martina Urbani ,&nbsp;Alessandro Favero ,&nbsp;Simon Spazzapan ,&nbsp;Fabio Puglisi ,&nbsp;Maurizio Mascarin ,&nbsp;Samuele Massarut ,&nbsp;Marco Trovò","doi":"10.1016/j.breast.2025.104459","DOIUrl":"10.1016/j.breast.2025.104459","url":null,"abstract":"<div><h3>Background and purpose</h3><div>To date, accelerated partial breast irradiation (APBI) regimens are highly heterogeneous. Twice-daily schedules show comparable local control to whole-breast radiotherapy but with worse toxicity and cosmesis profiles. Conversely, once-daily regimens are better tolerated, though dose and number of fractions are yet not standardized. Therefore, the aim of this study was to evaluate the efficacy and tolerability of three different once-daily APBI schedules.</div></div><div><h3>Materials and methods</h3><div>Three consecutive phase-2 trials were conducted at a single national cancer center to assess three once-daily APBI schedules (40Gy in 10 fractions, 35Gy in 7 fractions, and 28Gy in 4 fractions) delivered with 3D-conformal radiotherapy. All patients were at least 60 years old and had early-stage breast cancer (pT1-2,pN0-N1mic). Toxicity and cosmesis were evaluated by physicians using the CTCAE 4.0 scale and the Harvard score, respectively. Recurrence rates and survival outcomes at 5 and 10 years were estimated using the Kaplan-Meier method.</div></div><div><h3>Results</h3><div>A total of 189 patients were enrolled, with a median follow-up of 10.2 years. Patients treated with 40Gy in 10 fractions, 35Gy in 7 fractions and 28Gy in 4 fractions were 80 (42%), 73 (39%), and 36 (19%), respectively. Acute toxicity was low and comparable across schedules, whereas grade≥2 late toxicity and poor cosmesis were significantly worse with the shorter schedule. The 10-year estimated in-breast tumour recurrence rate was 5.5%, comparable to the limited literature reporting long-term outcomes.</div></div><div><h3>Conclusions</h3><div>Once-daily APBI delivered with 3D-conformal radiotherapy was effective; however, regimens with fewer than 5 fractions may be associated with increased toxicity and worse cosmesis.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"81 ","pages":"Article 104459"},"PeriodicalIF":5.7,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143704580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient perception on risk of recurrence and decision-making in the management of HER2-positive early breast cancer: Insights from the ASKHER2 European survey","authors":"Matteo Lambertini ,&nbsp;Christian Jackisch ,&nbsp;Olivier Trédan ,&nbsp;Maria Vidal ,&nbsp;Mário Fontes-Sousa ,&nbsp;Antonios Valachis ,&nbsp;Rosanna D'Antona ,&nbsp;Marcelo Ruz ,&nbsp;Eugenia Krone ,&nbsp;Miriam Brice ,&nbsp;Erwan Berjonneau ,&nbsp;Soraia Matos ,&nbsp;Olivia Dialla ,&nbsp;Laure Guéroult-Accolas","doi":"10.1016/j.breast.2025.104456","DOIUrl":"10.1016/j.breast.2025.104456","url":null,"abstract":"<div><h3>Background</h3><div>Perceived risk and fear of recurrence in patients with breast cancer (BC) is a matter of concern and may affect their health behaviours and their ability to participate in decision making during their treatment. This survey aimed to examine perceptions and concerns of patients with HER2+ BC.</div></div><div><h3>Materials and methods</h3><div>A multi-country, non-interventional, direct-to-patient online survey was conducted between July 22, 2022 and March 1, 2023 in six European countries using a multi-modal recruitment approach.</div></div><div><h3>Results</h3><div>Out of 622 included patients, 96.8 % desired involvement in treatment decisions, and 58.5 % felt they had significant influence in the decision-making process. A total of 20.9 % of patients were unaware of their personal risk of recurrence, and 19.5 % reported not discussing this risk with their healthcare providers. The fear of disease recurrence, death, and treatment failure were identified as the most important concerns. Moreover, 30.4 % perceived they had clear communication with healthcare providers on risk of recurrence. A total of 64.5 % were willing to take extra treatments, 60.2 % to undergo more surgery to reduce recurrence risk and 68.5 % were willing to accept further treatments even if recurrence risk decreased by less than 50 %.</div></div><div><h3>Conclusion</h3><div>Results of this multinational direct-to-patient study examining the perceptions and concerns of women with HER2+ breast cancer underscore the need for physicians to proactively involve patients in their decision-making process, enabling them to participate in a patient-centred approach during treatment decisions.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"81 ","pages":"Article 104456"},"PeriodicalIF":5.7,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143725419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Switching to T-DM1 remains justified in patients with HER2-negative residual invasive breast cancer after neoadjuvant therapy","authors":"Charles E. Geyer Jr. ,&nbsp;Sibylle Loibl","doi":"10.1016/j.breast.2025.104450","DOIUrl":"10.1016/j.breast.2025.104450","url":null,"abstract":"<div><div>Reductions in HER2-protein IHC intensity and <em>HER2</em>-gene amplification in residual invasive breast cancer following neoadjuvant therapy for HER2-positive breast cancer have been described and are associated with worse outcomes. T-DM1 requires initial binding to HER2 for activity, so concerns have been raised regarding T-DM1 activity when changes are sufficient to classify residual disease as HER2-negative. The KATHERINE trial assessed HER2 status of residual disease from 845 patients with HER2-positive status on pretherapy biopsies, of which 70 were negative on retesting. With 8 years of median follow-up, 7-year IDFS was 60.3 % with trastuzumab compared to 95.2 % with T-DM1, consistent with clinically meaningful benefit from T-DM1 in these 70 patients.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"81 ","pages":"Article 104450"},"PeriodicalIF":5.7,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143728530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CADONOT: Comparing axillary dissection or not in breast cancer surgery","authors":"André Mattar ,&nbsp;Marcelo Antonini ,&nbsp;Francisco Pimentel Cavalcante ,&nbsp;Felipe Zerwes ,&nbsp;Eduardo de Camargo Millen ,&nbsp;Fabricio Palermo Brenelli ,&nbsp;Antônio Luiz Frasson ,&nbsp;Patrícia Carvalho Baruel ,&nbsp;Lucas Miyake Okumura ,&nbsp;Leonardo Ribeiro Soares ,&nbsp;Marcelo Madeira ,&nbsp;Marina Diógenes Teixeira ,&nbsp;Andressa Gonçalves Amorim ,&nbsp;Larissa Chrispim de Oliveira ,&nbsp;Marcellus do Nascimento Moreira Ramos ,&nbsp;Gil Facina ,&nbsp;Ruffo de Freitas Junior ,&nbsp;Henrique Lima Couto ,&nbsp;Sabrina Monteiro Rondelo ,&nbsp;Renata Montarroyos Leite ,&nbsp;Juliana Monte Real","doi":"10.1016/j.breast.2025.104453","DOIUrl":"10.1016/j.breast.2025.104453","url":null,"abstract":"<div><h3>Introduction</h3><div>Sentinel lymph node biopsy (SLNB) is the gold standard for the axillary evaluation of clinically node-negative early breast cancer. The ACOSOG Z0011 study demonstrated the safety of omitting axillary dissection for limited SLNB disease, with other trials confirming SLNB alone or with axillary radiotherapy (AR) as non-inferior.</div></div><div><h3>Methods</h3><div>We followed PRISMA guidelines and registered at PROSPERO. Using Medline, Embase, and Cochrane, we reviewed randomized controlled trials (2010–2024). Outcomes, including 5-, 8-, and 10-year OS, DFS, recurrence rates, and lymphedema, were analyzed with R software and assessed for bias (Cochrane RoB) and evidence quality (GRADE). The focus was ALND vs. SLNB, alone or with AR, in cT1-T3 BC with 1–2 metastatic SLNs.</div></div><div><h3>Results</h3><div>Thirteen articles from seven randomized controlled trials (RCTs) were included, covering 7338 women with a follow-up period of 2.8–10 years. SLNB was associated with a 65 % lower risk of lymphedema than ALND, with no significant differences in the 5-, 8-, or 10-year OS, DFS, or recurrence rates. A meta-analysis comparing micrometastasis and macrometastasis showed no impact on outcomes, indicating that ALND may be unnecessary in either case. Recurrence rates also did not differ between SLNB and ALND, reinforcing SLNB's significantly lower lymphedema risk of SLNB.</div></div><div><h3>Conclusions</h3><div>This systematic review and meta-analysis support SLNB as a safe and effective alternative to ALND in early-stage BC with 1–2 positive SLNs, providing comparable survival and recurrence outcomes, with fewer complications.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"81 ","pages":"Article 104453"},"PeriodicalIF":5.7,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143820468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic factors and treatment insights for metastatic malignant phyllode tumors","authors":"Mengjia Han ,&nbsp;Yunyi Zhang ,&nbsp;Rong Lei ,&nbsp;Zijia Lai ,&nbsp;Zilin Zhuang ,&nbsp;Yulu Zhang ,&nbsp;Xun Li ,&nbsp;Xiaojun Li ,&nbsp;Rurong Jia ,&nbsp;Qiongchao Jiang ,&nbsp;Feng Ye ,&nbsp;Yan Nie","doi":"10.1016/j.breast.2025.104455","DOIUrl":"10.1016/j.breast.2025.104455","url":null,"abstract":"<div><h3>Background</h3><div>The aim of this study is to contribute a better understanding of metastatic malignant phyllode tumors (MMPTs) by exploring its prognostic factors, describing treatment landscape, and providing optimal treatment choices.</div></div><div><h3>Methods</h3><div>This retrospective multicentric study was included 43 patients with MMPTs who received treatment from 2009 to 2023 in four centers. The primary endpoint of the study was overall survival (OS).</div></div><div><h3>Results</h3><div>The median overall survival of these patients was 7.27 months (range: 0.63–118.53) and the median follow-up time was 16.8 months (range: 2–188). The median age of these patients were 49 years. The median metastasis-free survival (MFS, it is the time between initial diagnosis and diagnosis of metastatic disease) was 7.27 months, and the most common site of metastasis was lung (35/43, 81.4 %). Treatment for MMPTs primarily consisted of systemic chemotherapy and metastasectomy.</div><div>Multivariate analysis revealed that chemotherapy after metastasis (HR = 0.250, 95 % CI 0.109–0.571; <em>P</em> = 0.001) and MFS &gt;6 months (HR = 0.407, 95 % CI 0.198–0.836; P = 0.014) were independently associated with OS. The most common chemotherapy regimen was anthracyclines along with ifosfamide (AI), with the median progression-free survival of 5.5 months. Metastasectomy did not significantly improve OS.</div></div><div><h3>Conclusion</h3><div>The study findings highlight the significance of systemic treatment (chemotherapy) and the impact of MFS on prognosis of MMPTs. For these patients, systemic treatment may improve survival outcomes. And patients with MFS &lt;6 months appear to have a poorer prognosis.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"81 ","pages":"Article 104455"},"PeriodicalIF":5.7,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143685433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of surgical timing post-neoadjuvant chemotherapy on survival outcomes in breast cancer patients: A comprehensive systematic review and meta-analysis","authors":"Dandan Wang ,&nbsp;Xiaowei Sun ,&nbsp;Wen Sun ,&nbsp;Ruoxi Wang,&nbsp;Hong Pan,&nbsp;Wenbin Zhou","doi":"10.1016/j.breast.2025.104454","DOIUrl":"10.1016/j.breast.2025.104454","url":null,"abstract":"<div><h3>Background</h3><div>Increasing evidence supports the use of neoadjuvant chemotherapy (NAC) prior to surgery for breast cancer. However, the optimal timing between NAC and surgery had yet to be fully elucidated. This meta-analysis aims to assess how the optimal interval time (OTT) between NAC and surgery affects outcomes in breast cancer, providing additional evidence for clinical practice and future research.</div></div><div><h3>Methods</h3><div>PubMed<strong>,</strong> Web of Science and Cochrane Library databases in English were systematically searched for this systematic review. All included studies investigated the variations in surgical timing following NAC and their effects on breast cancer outcomes. The endpoints included the rate of pathological complete response (pCR), overall survival (OS), recurrence free survival (RFS), and disease-free survival (DFS). This study has been registered with PROSPERQ.</div></div><div><h3>Results</h3><div>Eleven eligible studies were identified, encompassing a total of 10,834 cases, all of which received surgery post-NAC. All studies were retrospective in nature. Ultimately, compared to intervals within 4 weeks, patients who underwent surgery&gt;8weeks post-NAC demonstrated a statistically significant worse OS (HR = 1.21, 95 % <em>CI</em>: 1.06–1.40, <em>p</em> = 0.333 for heterogeneity). No significant difference of OS was observed between patients with OTT of 4–8 weeks vs &lt; 4 weeks. Notably, patients with an OTT of 4–8 weeks (HR = 1.18, 95 % <em>CI</em>: 1.10–1.26, <em>I</em>^<em>2</em> = 0.0 %, p = 0.931 for heterogeneity) and&gt;8weeks (HR = 1.21, 95 % <em>CI</em>: 1.13–1.29, <em>I</em>^<em>2</em> = 36.2 %, <em>p</em> = 0.195 for heterogeneity) exhibited decreasing RFS, compared with those with OTTs of&lt;4 weeks. DFS and pCR rates were similar in&gt;8weeks vs &lt; 4 weeks and 4–8weeks vs &lt; 4 weeks.</div></div><div><h3>Conclusion</h3><div>Our systematic review and meta-analysis indicate that the optimal interval following NAC for breast cancer patients might be within four weeks, as delays exceeding eight weeks could be associated with poorer clinical outcomes. However, additional research is necessary to validate these preliminary findings.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"81 ","pages":"Article 104454"},"PeriodicalIF":5.7,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143685419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world palbociclib dose modifications and clinical outcomes in patients with HR+/HER2− metastatic breast cancer: A Flatiron Health database analysis","authors":"Rachel M. Layman ,&nbsp;Xianchen Liu ,&nbsp;Benjamin Li ,&nbsp;Lynn McRoy ,&nbsp;Adam Brufsky","doi":"10.1016/j.breast.2025.104448","DOIUrl":"10.1016/j.breast.2025.104448","url":null,"abstract":"<div><h3>Purpose</h3><div>To examine the associations of palbociclib dose modifications with clinical outcomes of patients with HR+/HER2− metastatic breast cancer (MBC) treated with first-line (1L) palbociclib + aromatase inhibitor (AI) in routine practice.</div></div><div><h3>Methods</h3><div>Using the Flatiron Health Analytic Database, we conducted a retrospective analysis of HR+/HER2− MBC patients who started 1L palbociclib + AI February 2015–March 2020. Kaplan−Meier analyses were used to estimate treatment duration, real-world progression-free survival (rwPFS), and overall survival (OS) by palbociclib dose adjustments (any change in palbociclib daily dose while on treatment) and dose reductions (starting dose &lt;125 mg/day or dose reduced while on treatment). Cox proportional hazard regression models were performed to compute unadjusted/adjusted hazard ratios (HRs).</div></div><div><h3>Results</h3><div>Of 1302 patients with documented starting dose, 524 (40.2 %) had palbociclib dose adjustments; 778 (59.8 %) had none. Median treatment duration was significantly longer in patients with dose adjustments versus those with none (27.4 vs 21.4 months; adjusted HR = 0.80 [95 % CI, 0.69–0.93]; <em>P</em> = 0.004). Patients with and without dose adjustments showed similar median rwPFS (20.5 vs 19.6 months; adjusted HR = 0.89 [95 % CI, 0.76–1.04]; <em>P</em> = 0.133). Median OS was significantly prolonged in patients with versus without dose adjustments (57.8 vs 51.4 months; adjusted HR = 0.73 [95 % CI, 0.59–0.89]; <em>P</em> = 0.002). Similar findings were observed in patients with and without dose reductions.</div></div><div><h3>Conclusions</h3><div>In this real-world study, rwPFS in HR+/HER2− MBC patients was maintained irrespective of dose adjustments. However, dose adjustments were associated with extended treatment duration and OS.</div></div><div><h3>Clinical trial registration</h3><div><span><span>NCT05361655</span><svg><path></path></svg></span> (<span><span>ClinicalTrials.gov</span><svg><path></path></svg></span>)</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"81 ","pages":"Article 104448"},"PeriodicalIF":5.7,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143695963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}