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Purpose <p>Estrogen receptor-low (ER-low) breast cancer (BC) present clinicopathological features and disease behavior resembling triple-negative breast cancer, but have been frequently excluded from pivotal trials designed for the latter. Since neoadjuvant pembrolizumab plus chemotherapy (P + CT) is the new standard of care for stage II-III triple-negative breast cancer (TNBC), we aimed to access the effectiveness of this therapy for ER-low tumors.</p> Methods <p>We evaluated patients with ER-low BC included in the Neo-Real/ GBECAM-0123 study, a real-world data study evaluating patients treated with neoadjuvant P + CT since July 2020 across ten cancer centers. The objective of this study was to evaluate the effectiveness of neoadjuvant P + CT through pathologic complete response (pCR).</p> Results <p>Twenty patients were included in this analysis. Median age was 40&#xa0;years (range 28–64). Most patients had grade 3 tumors (n = 18, 90%), with a median Ki67 index of 75% (range 30–95%), and 70% had stage II tumors.</p> <p>All the twenty patients were submitted to surgery, with a pCR observed in 12 cases (pCR rate of 60%). Receiving less than 6 cycles of pembrolizumab was associated with a trend towards worse pCR rates (20% vs 73.3%).</p> Conclusions <p>The clinicopathological features and the response to neoadjuvant P + CT observed in this ER-low BC cohort are similar to that observed in TNBC. Patients with stage II-III ER-low/HER2- BC should be treated with neoadjuvant P + CT following the treatment standards for TNBC, and proper adherence to the regimen is relevant to improve effectiveness.</p>

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Pathologic complete response rates of patients with ER-low/HER2-negative breast cancer treated with neoadjuvant pembrolizumab plus chemotherapy in the neo-real study

  • 期刊论文

  • 发表日期：

    2025年2月3日

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  • Renata Colombo Bonadio,
  • Monique Celeste Tavares,
  • Flávia Cavalcanti Balint,
  • Isadora Martins de Sousa,
  • Ana Carolina Marin Comini,
  • Fernanda Madasi,
  • Jose Bines,
  • Rafael Dal Ponte Ferreira,
  • Daniela Dornelles Rosa,
  • Candice Lima Santos,
  • Zenaide Silva de Souza,
  • Daniele Assad-Suzuki,
  • Júlio Antônio Pereira de Araújo,
  • Débora de Melo Gagliato,
  • Carlos Henrique dos Anjos,
  • Bruna M. Zucchetti,
  • Anezka Ferrari,
  • Mayana Lopes de Brito,
  • Renata Cangussu,
  • Maria Marcela Fernandes Monteiro,
  • Paulo M. Hoff,
  • Laura Testa,
  • Maria del Pilar Estevez-Diz,
  • Romualdo Barroso-Sousa

摘要

Purpose

Estrogen receptor-low (ER-low) breast cancer (BC) present clinicopathological features and disease behavior resembling triple-negative breast cancer, but have been frequently excluded from pivotal trials designed for the latter. Since neoadjuvant pembrolizumab plus chemotherapy (P + CT) is the new standard of care for stage II-III triple-negative breast cancer (TNBC), we aimed to access the effectiveness of this therapy for ER-low tumors.

Methods

We evaluated patients with ER-low BC included in the Neo-Real/ GBECAM-0123 study, a real-world data study evaluating patients treated with neoadjuvant P + CT since July 2020 across ten cancer centers. The objective of this study was to evaluate the effectiveness of neoadjuvant P + CT through pathologic complete response (pCR).

Results

Twenty patients were included in this analysis. Median age was 40 years (range 28–64). Most patients had grade 3 tumors (n = 18, 90%), with a median Ki67 index of 75% (range 30–95%), and 70% had stage II tumors.

All the twenty patients were submitted to surgery, with a pCR observed in 12 cases (pCR rate of 60%). Receiving less than 6 cycles of pembrolizumab was associated with a trend towards worse pCR rates (20% vs 73.3%).

Conclusions

The clinicopathological features and the response to neoadjuvant P + CT observed in this ER-low BC cohort are similar to that observed in TNBC. Patients with stage II-III ER-low/HER2- BC should be treated with neoadjuvant P + CT following the treatment standards for TNBC, and proper adherence to the regimen is relevant to improve effectiveness.