Breast Cancer Research and Treatment最新文献

{"title":"Long-term outcomes of eribulin‑based neoadjuvant chemotherapy for triple‑negative breast cancer patients stratified by homologous recombination deficiency status: results of the randomized JBCRG-22 study.","authors":"Norikazu Masuda, Hiroyuki Yasojima, Hiroko Bando, Takashi Yamanaka, Hideo Shigematsu, Masato Takahashi, Shigenori E Nagai, Mitsuya Ito, Tomoyuki Aruga, Mariko Tokiwa, Shigeru Imoto, Rikiya Nakamura, Hiroshi Ishiguro, Hidetaka Kawabata, Shigehira Saji, Hironori Haga, Satoshi Morita, Masakazu Toi","doi":"10.1007/s10549-026-07917-5","DOIUrl":"10.1007/s10549-026-07917-5","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate long-term outcomes for triple‑negative breast cancer (TNBC) patients enrolled in JBCRG-22.</p><p><strong>Methods: </strong>TNBC (cT1c-T3, cN0-1, M0) patients were stratified by homologous recombination deficiency (HRD) and germline BRCA mutation (gBRCAm) status. Group A patients (aged < 65 years with HRD-positive tumors, or those with gBRCAm, if available) were randomized to receive 4 cycles of weekly paclitaxel (group A1) or eribulin (group A2), both with carboplatin, followed by 4 cycles of anthracycline. Group B patients (aged < 65 years with HRD-negative tumors or aged ≥ 65 years) were randomized to receive 6 cycles of eribulin plus cyclophosphamide (group B1) or eribulin plus capecitabine (group B2). Five-year invasive disease-free survival (IDFS), distant disease-free survival (DDFS), and overall survival (OS) were assessed. Additionally, data were analyzed by biomarker levels including lymphocyte count (LC) and neutrophil-to-lymphocyte ratio (NLR).</p><p><strong>Results: </strong>Ninety-nine patients were followed for a median of 5.6 years. In patients who received eribulin-based therapy (groups A2 + B1 + B2), 5-year IDFS and OS rates, respectively, were 95% and 100% in patients who achieved pCR after neoadjuvant therapy (n = 20) and 71.4% and 80.2% in those who did not (n = 56), showing significantly better prognosis in the pCR cohort (p < 0.05). OS tended to be better in patients with baseline LC ≥ 1500/mm³ and NLR < 3, particularly in eribulin-treated patients, although differences were non-significant.</p><p><strong>Conclusions: </strong>These findings will help guide the development of eribulin-based neoadjuvant chemotherapy for selected TNBC patients. Our exploratory analysis of LC and NLR results may help inform clinical prediction models for eribulin-treated patients.</p><p><strong>Trial registration: </strong>The study has been registered with the University Hospital Medical Information Network Clinical Trials Registry ( https://www.umin.ac.jp/ctr/index-j.htm ) with unique trial number UMIN000023162. The Japan Breast Cancer Research Group trial number is JBCRG-22.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"216 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13002658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147484494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: A Canadian real‑world, multi‑center, prospective, observational study assessing the treatment duration, the treatment sequence, and the overall survival for patients treated with endocrine therapy ± targeted therapy in HR + HER2‑negative advanced breast cancer.","authors":"Catherine Doyle, Ana Elisa Lohmann, Nayyer Iqbal, Jan-Willem Henning, Swati Kulkarni, Nadia Califaretti, John Hilton, Cristiano Ferrario, Nathaniel Bouganim, Mihaela Mates, Stephanie Guillemette, Ricardo Leite, Marc-Andre Caron, Francois Thireau, Andres Machado, Stephen Chia","doi":"10.1007/s10549-026-07934-4","DOIUrl":"10.1007/s10549-026-07934-4","url":null,"abstract":"","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"216 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13002762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147484443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Omission of axillary surgery in early breast cancer with negative lymph nodes: a systematic review and meta-analysis of randomized clinical trials.","authors":"Bárbara Bizzo Castelo, Luiz Gustavo Oliveira Brito, Renato Zocchio Torresan, Cássio Cardoso Filho, Giuliano Mendes Duarte","doi":"10.1007/s10549-026-07910-y","DOIUrl":"10.1007/s10549-026-07910-y","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate whether the omission of axillary surgery impacts clinical outcomes in patients with early-stage breast cancer and clinically negative lymph nodes.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis of randomized clinical trials (RCTs) comparing no axillary surgery with standard axillary interventions (sentinel lymph node biopsy [SLNB] or axillary dissection [AD]). This study followed PRISMA guidelines and was registered in PROSPERO (CRD420250653779). Searches were conducted in PubMed, Web of Science, and Embase through June 2025. Outcomes assessed included overall survival (OS), disease-free survival (DFS), and axillary recurrence (AR). Meta-analyses were performed using RevMan 5.4. Risk of bias was assessed using the RoB 2 tool.</p><p><strong>Results: </strong>Out of 853 records, seven RCTs including 8806 patients met the inclusion criteria. Among them, 2,915 patients underwent no axillary surgery, while 5891 received surgical axillary treatment. Two trials compared no surgery with SLNB, and five compared no surgery with AD. No significant differences were found in OS (OR = 1.02; 95% CI, 0.86-1.20; p = 0.84; I² = 36%) or DFS (OR = 0.80; 95% CI, 0.63-1.00; p = 0.05; I² = 63%). AR was significantly lower in the axillary surgery group (OR = 0.18; 95% CI, 0.10-0.31; p < 0.01; I² = 39%).</p><p><strong>Conclusion: </strong>The omission of axillary surgery in early-stage breast cancer with clinically negative lymph nodes does not negatively impact overall or disease-free survival. However, it is associated with a higher-though still low-risk of axillary recurrence.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"216 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12999590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147479842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ESR1 polymorphisms were associated with aromatase inhibitors induced musculoskeletal symptoms in breast cancer patients.","authors":"Feng Jing, Lingyun Jiang, Yuling Cao, Maoting Tian, Jiajia Qiu, Lichen Tang, Yan Hu","doi":"10.1007/s10549-026-07927-3","DOIUrl":"10.1007/s10549-026-07927-3","url":null,"abstract":"<p><strong>Purpose: </strong>Aromatase Inhibitors Associated Musculoskeletal Symptoms (AIMSS) are common side effects among hormone receptor-positive breast cancer patients, significantly affecting patients' treatment adherence and quality of life. The individual genetic susceptibility mechanism underlying AIMSS was not well understood yet. This study aimed to validate the association between genetic polymorphisms and AIMSS among Chinese breast cancer patients.</p><p><strong>Methods: </strong>This was a cross-sectional study. Participants were recruited from a tertiary hospital in China from May 2023 to June 2024. Musculoskeletal symptoms were measured using the Modified Score for the Assessment of Chronic Rheumatoid Affections of the Hands (M-SACRAH) and the Western Ontario and McMaster Osteoarthritis Index (WOMAC) among hormone receptor-positive patients receiving aromatase inhibitor therapy. Six genes (i.e., ESR1, ESR2, RANK, OPG, TCL1A and CYP19A1) related 20 SNPs were tested. Multivariate linear regression analysis was used to explore the association between different genotypes and the severity of AIMSS.</p><p><strong>Results: </strong>Among 171 participants, the standardized M-SACRAH score was 3.33 (IQR 0.00-9.17) and the standardized WOMAC score was 5.83 (IQR 2.08-17.29). Patients carrying the ESR1 rs9340799 AG genotype (vs. AA) had a significant reduction in the severity of hand joint symptoms [adjusted β = -4.51, 95% CI: -8.29, -0.73, p = 0.020] and knee/hip joint symptoms [adjusted β = -4.44, 95% CI: -8.49, -0.39, p = 0.032]. The ESR1 rs2077647 TC genotype (vs. TT) was related to lower level of hand joint symptoms [adjusted β = -5.03, 95% CI: -8.69, -1.37, p = 0.007] and knee/hip joint symptoms [adjusted β = -5.04, 95% CI: -8.97, -1.12, p = 0.012]. The ESR1 rs2234693 TC genotype (vs. TT) [adjusted β = -4.06, 95% CI: -8.09, -0.03, p = 0.049] was associated with lower level of knee/hip joint symptoms. No significant associations emerged between ESR2, RANKL, OPG, TCL1A, or CYP19A1 variants and AIMSS.</p><p><strong>Conclusions: </strong>This study preliminarily validated the association between ESR1 polymorphisms (rs9340799, rs2077647, and rs2234693) and aromatase inhibitor associated musculoskeletal symptoms in hormone receptor-positive breast cancer among Chinese patients. Future research should focus on dissecting their molecular mechanisms, and integrating genetic data with clinical interventions to optimize the management strategies of musculoskeletal toxicity.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"216 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147479806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment patterns and safety of adjuvant therapy after chemoimmunotherapy for early-stage triple-negative breast cancer: real-world data from the Neo-Real/GBECAM 0123 study.","authors":"Matheus de Oliveira Andrade, Renata Colombo Bonadio, Agustina Ipiña, Laura Testa, Monique Celeste Tavares, Flávia Cavalcanti Balint, Carlos Henrique Dos Anjos, Débora de Melo Gagliato, Mayana Lopes de Brito, Melina Winocur, Daniele Assad-Suzuki, Daniela Dornelles Rosa, Noele de Jesus Barros Gomes, Natalia Cristina Cardoso Nunes, Isadora Martins de Sousa, Mariana Carvalho Gouveia, Fernanda Madasi, Jose Bines, Carlos Gallina, Rafael Dal Ponte Ferreira, Candice Lima Santos, Maira Tavares, Mariana Ribeiro Monteiro, Zenaide Silva de Souza, Ana Maria Ulbricht Gomes, Bruna M Zucchetti, Anezka Ferrari, Maria Marcela Fernandes Monteiro, Poliana Albuquerque Signorini, Solange Sanches, Paulo M Hoff, Gimena Ferreira, Maria Del Pilar Estevez-Diz, Romualdo Barroso-Sousa","doi":"10.1007/s10549-026-07938-0","DOIUrl":"10.1007/s10549-026-07938-0","url":null,"abstract":"<p><strong>Purpose: </strong>For early-stage triple-negative breast cancer (TNBC), the KEYNOTE-522 trial established neoadjuvant pembrolizumab plus chemotherapy (CT), followed by adjuvant pembrolizumab, as the standard of care. Nevertheless, uncertainties remain on how to integrate this regimen with other adjuvant therapies such as capecitabine or olaparib. This study evaluated real-world treatment patterns and safety of adjuvant therapies following neoadjuvant chemoimmunotherapy.</p><p><strong>Methods: </strong>The Neo-Real study includes patients with TNBC treated with neoadjuvant pembrolizumab plus CT in Brazil and Argentina. This study describes real-world adjuvant treatment patterns and safety; survival outcomes are not reported in this analysis.</p><p><strong>Results: </strong>Among 726 patients included, 692 underwent surgery, and 62.9% achieved pathologic complete response (pCR). Of those with pCR, 84.8% received adjuvant pembrolizumab alone, while 14.3% received no adjuvant therapy. Among patients with residual disease and no germline BRCA1/2 mutations (n = 207), 57.5% received pembrolizumab plus capecitabine, 26.1% pembrolizumab alone, and 12.6% capecitabine alone. In BRCA1/2-mutated patients (n = 26), 57.7% received pembrolizumab plus olaparib, 19.2% pembrolizumab alone, and 11.5% olaparib alone. Safety data were available for 359 patients. Adjuvant pembrolizumab alone caused a lower incidence of grade ≥ 3 AEs (6.7%) compared with combination regimens (P = 0.002). Drug discontinuation due to toxicity occurred in 5.7%, 11.2%, and 7.7% of patients receiving pembrolizumab, pembrolizumab + capecitabine, and pembrolizumab + olaparib, respectively (P = 0.126).</p><p><strong>Conclusion: </strong>Most patients with pCR continued adjuvant pembrolizumab, while combination strategies predominated among those with residual disease and were associated with higher rates of grade ≥ 3 AEs. The efficacy of these combined regimens remains to be determined.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"216 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147479827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on: \"Prognostic performance of thymidine kinase 1 activity in patients with hormone receptor-positive and HER2-negative metastatic breast cancer treated with CDK4/6 and aromatase inhibitors\".","authors":"Sangameshwar Manikya, Varshini Vadhithala, Rajnish Kumar, Pankaj Nainwal","doi":"10.1007/s10549-026-07946-0","DOIUrl":"10.1007/s10549-026-07946-0","url":null,"abstract":"","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"216 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147479829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unlocking the predictive value of post-neoadjuvant immune biomarkers in breast cancer: neutrophil-to-lymphocyte ratio (NLR) and systemic immune-inflammation index (SII).","authors":"María Esperanza Guirao García, Pedro Marín Rodríguez, Carmen María Servet Pérez de Lema, Noel Blaya Boluda, Pilar Sánchez Henarejos, Miguel Ángel Moya Hernández, Andrea Gottlob Pérez, Caridad Marín Hernández, Pilar de la Morena Barrio, Elisa García Garre, Elena García-Martínez, Francisco Ayala de la Peña, Antonio Piñero Madrona, Esmeralda García-Torralba","doi":"10.1007/s10549-026-07928-2","DOIUrl":"10.1007/s10549-026-07928-2","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the potential prognostic value of two peripheral immune biomarkers-neutrophil-to-lymphocyte ratio (NLR) and systemic immune-inflammation index (SII)-in breast cancer patients treated with neoadjuvant chemotherapy, and to assess their association with pathological complete response (pCR) and other predictive factors. In addition, to determine whether prognostic or predictive differences exist between baseline and post-neoadjuvant values of these biomarkers.</p><p><strong>Methods: </strong>We analyzed 801 women with early breast cancer treated with neoadjuvant chemotherapy, evaluating clinical and pathological data, survival outcomes, NLR (continuous and categorical) and SII.</p><p><strong>Results: </strong>Baseline NLR was significantly higher in younger patients, in those with positive pathological nodes, and in the HER2 + /HR - subtype, while baseline SII was elevated in the triple-negative subtype. Post-neoadjuvant chemotherapy (post-NCT) NLR and SII showed only weak associations with estrogen receptor expression, yet both were independently associated with pCR (post-NCT NLR: OR = 0.91; 95% CI: 0.84-0.98; p = 0.02; post-NCT SII: OR = 0.65; 95% CI: 0.47-0.89; p = 0.008). Neither biomarker showed a significant impact on overall or progression-free survival.</p><p><strong>Conclusion: </strong>Post-treatment NLR and SII may reflect chemotherapy-induced immune changes and are associated with pathological complete response, but their additional predictive value is uncertain, and no prognostic impact was observed.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"216 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12992397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147466897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular imaging of tucatinib-induced cellular and TME changes in preclinical models of HER2 + breast cancer.","authors":"Patrick N Song, Ameer Mansur, Carlos A Gallegos, Pragya Ghanate, Suzanne E Lapi, Anna G Sorace","doi":"10.1007/s10549-026-07936-2","DOIUrl":"10.1007/s10549-026-07936-2","url":null,"abstract":"<p><strong>Introduction: </strong>Tucatinib, a small molecule HER2 inhibitor, was approved in inoperable or metastatic HER2 + breast cancer. As many patients have tumors in challenging surgical locations, there is a need for imaging metrics to characterize tucatinib response and microenvironment impact. Molecular imaging can be used to quantify dynamic molecular changes that precede tumor size alterations and can target proliferation (fluorothymidine, [¹⁸F]-FLT), hypoxia (fluoromisonidazole, [¹⁸F]-FMISO) and HER2 expression ([⁸⁹Zr]-Pertuzumab) with positron emission tomography (PET) imaging. The goal of this study is to non-invasively characterize tucatinib response in HER2 + breast cancer and quantify microenvironment modulation with advanced PET imaging.</p><p><strong>Methods: </strong>Mice with HER2 + human cell line (BT474) or patient derived xenograft (BCM 3472) tumors were treated with 50 mg/kg tucatinib and enrolled into imaging cohorts: imaged with [¹⁸F]-FLT-PET on days 0, 3 and 7, [¹⁸F]-FMISO-PET on days 0, 3 and 7, or [⁸⁹Zr]Zr-Pertuzumab-PET on days 0 and 14. Proliferation, hypoxia and HER2 expression were quantified with standardized uptake value. A Mann-Whitney U Test assessed significance between groups.</p><p><strong>Results: </strong>Tucatinib-treated human cell line and PDX tumors had significantly decreased hypoxia and proliferation relative to control tumors (p < 0.05). Tucatinib-treated BT474 tumors had significantly decreased HER2 expression (p < 0.05); however, no significant HER2 change was observed in BCM3472 tumors.</p><p><strong>Conclusion: </strong>Tucatinib significantly decreases intratumoral proliferation and hypoxia in both cell-line and patient-derived xenograft models of HER2 + breast cancer, which can be longitudinally quantified with PET imaging. Our data suggests molecular imaging may improve understanding and prediction of tucatinib response.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"216 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12987860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147455773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing infectious risk of Trastuzumab-deruxtecan to Trastuzumab-emtansine in patients with breast cancer.","authors":"Scott Gayfield, Jianing Ma, Michael Waleski, Joanne Kim, Daniel Stover, Margaret Gatti-Mays, Sachin R Jhawar, Kai Johnson, Zeinab El Boghdadly, Kevin Ho","doi":"10.1007/s10549-026-07937-1","DOIUrl":"10.1007/s10549-026-07937-1","url":null,"abstract":"<p><strong>Purpose: </strong>Trastuzumab-deruxtecan (T-DXd) is an antibody-drug conjugate (ADC) that revolutionized the treatment approach for breast cancer. However, the infectious risk associated with T-DXd is unknown. Here, we evaluate the infectious risk of T-DXd against trastuzumab-emtansine (T-DM1), an ADC with an identical monoclonal antibody.</p><p><strong>Methods: </strong>We conducted a retrospective study of consecutive breast cancer patients who received T-DXd or T-DM1. Demographic data, infection risk factors, infection sites, and opportunistic infections were recorded and compared across treatment groups. Multivariable logistic regression was used to evaluate the association between treatment group and infection, adjusting for clinical risk factors.</p><p><strong>Results: </strong>374 patients received T-DXd or T-DM1, with 126 receiving T-DXd alone, 196 receiving T-DM1 alone, and 52 patients receiving both treatments. Patients who received T-DXd did so as higher line of therapy (p < 0.001), was given more in the palliative setting (100% vs 33.7%, p < 0.001), had more prior immunosuppressive systemic treatment (78.6% vs 16.9%, p < 0.001), were exposed to more significant corticosteroid courses (17.2% vs 4.5%, p < 0.001), and had more hospitalizations during treatment (57.3% vs 27.7%, p < 0.001). Patients treated with T-DXd had a higher incidence of total infections (24.4% vs 14.0%, p = 0.01); in the infected population, unadjusted analysis reveals that those treated with T-DXd had more bloodstream infections (33.3% vs 5.9%, p = 0.004) and more infection-related mortality (18.2% vs 0%, p = 0.01). Three patients developed opportunistic infections on T-DXd, and 2 of the 3 were treated concurrently with high-dose corticosteroids. For multivariate analysis, after adjustment for clinically relevant variables and those associated with the outcome in univariate analyses, T-DXd was not associated with an increased risk of infection (OR = 1.89, 95% CI: 0.85-4.32, p = 0.12).</p><p><strong>Conclusion: </strong>Although patients receiving T-DXd had a higher incidence of infection, no significant difference in infectious risk was found after adjusting for several confounding variables. Infection-related mortality and opportunistic infections were rare and only occurred in the T-DXd cohort. Future prospective studies are warranted to more reliably evaluate the infectious risk of T-DXd compared to T-DM1, particularly as T-DXd is increasingly utilized earlier in the treatment course for breast cancer patients.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"216 2","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12967492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147372383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A phase II study of atezolizumab in combination with stereotactic radiation for patients with triple-negative breast cancer and brain metastasis.","authors":"Antonio Giordano, Noah Graham, Ayal A Aizer, Nabihah Tayob, Alyssa M Pereslete, Jonathan D Schoenfeld, Jose Pablo Leone, Raechel Davis, Timothy K Erick, Erica L Mayer, Eric P Winer, Ian Krop, Sara M Tolaney, Nancy U Lin","doi":"10.1007/s10549-026-07932-6","DOIUrl":"10.1007/s10549-026-07932-6","url":null,"abstract":"<p><strong>Purpose: </strong>Triple-negative breast cancer (TNBC) patients with brain metastases have a poor prognosis and limited treatment options. Preclinical and clinical evidence suggests that radiotherapy may act synergistically with immune checkpoint inhibitors.</p><p><strong>Methods: </strong>We conducted an open-label, single-arm, phase II study of atezolizumab plus stereotactic radiosurgery (SRS) in metastatic TNBC patients with brain metastases. The primary endpoint was progression-free survival (PFS) according to the Response Assessment in Neuro-Oncology Brain Metastases (RANO-BM) bi-compartmental model. Secondary endpoints included extracranial objective response rate, overall survival (OS), and safety and tolerability. A safety run-in analysis for dose-limiting toxicity (DLT) was performed after the first 6 patients were enrolled and completed the assessment period.</p><p><strong>Results: </strong>Six patients were enrolled into the safety run-in phase between May 11, 2018 and October 24, 2019. No DLTs were observed, but the study was closed early due to slow accrual. Patients received a median of 2 atezolizumab cycles (range: 2-16), and SRS was administered to all 6 patients. Treatment-related adverse events (TRAEs) occurred in 4 participants (66.7%); all events were grade 2. The median bi-compartmental PFS was 1.3 months (95% confidence interval (CI): 0.95 - NA) and the median OS was 9.7 months (95% CI: 3.6 - NA). The best observed response by RECIST 1.1 criteria was stable disease ≥ 24 weeks in one participant (16.7%).</p><p><strong>Conclusions: </strong>Concurrent SRS with atezolizumab was feasible in TNBC patients with brain metastases. However, disease outcomes were poor, and the development of effective therapies for these patients remains a significant unmet medical need.</p><p><strong>Clinical trial registry number: </strong>https://www.</p><p><strong>Clinicaltrials: </strong>gov NCT03483012. Trial Open to Accrual: 05/01/2018.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"216 2","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12967526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147372421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}