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Background and Objectives <p>Triple-negative breast cancer (TNBC) has a poor prognosis, and neoadjuvant chemotherapy (NACT) is the standard treatment for locally advanced TNBC. In this study, we aimed to evaluate the efficacy of adding carboplatin to NACT regarding pathological complete response (pCR) and survival in the HER2-low and HER2-zero subgroups of TNBC patients.</p> Materials and Methods <p>The study included 269 patients from five medical oncology clinics. Patients were divided into two groups: HER2-low (<i>n</i> = 152, 56.5%) and HER2-zero (<i>n</i> = 117, 43.5%). Among HER2-zero patients, 30 (25.6%) received carboplatin, while 38 (25.0%) HER2-low patients received carboplatin. The benefit of adding carboplatin to NACT regarding pCR and survival was assessed in both HER2-zero and HER2-low groups.</p> Results <p>When patients were evaluated according to HER2 status, the pCR rates were significantly higher in the HER2-zero group compared to the HER2-low group (45.2% versus 23.7%, <i>p</i> &lt; 0.001). In the HER2-zero group, patients who received carboplatin had significantly higher pCR rates (63.3% versus 39.0%, <i>p</i> = 0.021). Similarly, in the HER2-low group, adding carboplatin significantly increased the pCR rates (36.8% versus 19.3%, <i>p</i> = 0.028). While carboplatin improved pCR rates in both HER2 subgroups, this benefit was not observed in patients with Grade 1 tumors, HER2 score 2-FISH negative tumors, or based on <i>BRCA</i> mutation status. Patients with pCR exhibited significantly prolonged DFS and OS (<i>p</i> = 0.002, <i>p</i> &lt; 0.001, respectively).</p> Conclusions <p>Our research demonstrates that the addition of carboplatin increases pCR rates in both HER2-zero and HER2-low patient cohorts. We suggest that carboplatin should be considered as an addition to standard neoadjuvant chemotherapy for eligible TNBC patients, regardless of HER2-zero or HER2-low status, when appropriate based on individual patient factors and toxicity considerations.</p>

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The impact of carboplatin on pathologic complete response and survival based on HER2 low and HER2 zero status in triple negative breast cancer patients receiving neoadjuvant chemotherapy: a multicenter real-world analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年5月6日

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  • Sedat Yıldırım,
  • Tugba Başoğlu,
  • Akif Doğan,
  • Goncagul Akdağ,
  • Oguzcan Kınıkoğlu,
  • Alper Topal,
  • Ozkan Alan,
  • Ali Alper Solmaz,
  • Mustafa Gürbüz,
  • Timucin Çil,
  • Rumeysa Çolak,
  • Mesut Yılmaz,
  • Ali Kalem,
  • Nadiye Sever,
  • Nargiz Majıdova,
  • Kubilay Karakoyun,
  • Serhat Sekmek,
  • Omer Saçlı,
  • Melike Ozcelık,
  • Deniz Işık,
  • Heves Surmeli,
  • Ozlem Nuray Sever,
  • Hatice Odabas,
  • Mahmut Emre Yıldırım,
  • Nedim Turan

摘要

Background and Objectives

Triple-negative breast cancer (TNBC) has a poor prognosis, and neoadjuvant chemotherapy (NACT) is the standard treatment for locally advanced TNBC. In this study, we aimed to evaluate the efficacy of adding carboplatin to NACT regarding pathological complete response (pCR) and survival in the HER2-low and HER2-zero subgroups of TNBC patients.

Materials and Methods

The study included 269 patients from five medical oncology clinics. Patients were divided into two groups: HER2-low (n = 152, 56.5%) and HER2-zero (n = 117, 43.5%). Among HER2-zero patients, 30 (25.6%) received carboplatin, while 38 (25.0%) HER2-low patients received carboplatin. The benefit of adding carboplatin to NACT regarding pCR and survival was assessed in both HER2-zero and HER2-low groups.

Results

When patients were evaluated according to HER2 status, the pCR rates were significantly higher in the HER2-zero group compared to the HER2-low group (45.2% versus 23.7%, p < 0.001). In the HER2-zero group, patients who received carboplatin had significantly higher pCR rates (63.3% versus 39.0%, p = 0.021). Similarly, in the HER2-low group, adding carboplatin significantly increased the pCR rates (36.8% versus 19.3%, p = 0.028). While carboplatin improved pCR rates in both HER2 subgroups, this benefit was not observed in patients with Grade 1 tumors, HER2 score 2-FISH negative tumors, or based on BRCA mutation status. Patients with pCR exhibited significantly prolonged DFS and OS (p = 0.002, p < 0.001, respectively).

Conclusions

Our research demonstrates that the addition of carboplatin increases pCR rates in both HER2-zero and HER2-low patient cohorts. We suggest that carboplatin should be considered as an addition to standard neoadjuvant chemotherapy for eligible TNBC patients, regardless of HER2-zero or HER2-low status, when appropriate based on individual patient factors and toxicity considerations.