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Pathologic complete response rates of patients with ER-low/HER2-negative breast cancer treated with neoadjuvant

Renata Colombo Bonadio1,2,3, Monique Celeste Tavares4, Flávia Cavalcanti Balint4

  • 1Instituto D'Or de Pesquisa E Ensino (IDOR), São Paulo, Brazil.

Breast Cancer Research and Treatment
|February 3, 2025
PubMed
Summary

Neoadjuvant pembrolizumab plus chemotherapy (P+CT) shows promise for estrogen receptor-low (ER-low) breast cancer (BC), achieving a 60% pathologic complete response (pCR) rate. Adherence to the full P+CT regimen is crucial for optimal effectiveness in ER-low BC.

Keywords:
Breast cancerER-lowImmunotherapyNeoadjuvant

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Area of Science:

  • Oncology
  • Medical Research
  • Clinical Trials

Background:

  • Estrogen receptor-low (ER-low) breast cancer (BC) shares characteristics with triple-negative breast cancer (TNBC).
  • ER-low BC has been historically excluded from clinical trials targeting TNBC.
  • Neoadjuvant pembrolizumab plus chemotherapy (P+CT) is the established standard for TNBC.

Purpose of the Study:

  • To assess the efficacy of neoadjuvant P+CT in patients with ER-low BC.
  • To compare the response of ER-low BC to P+CT with that of TNBC.
  • To determine the impact of treatment adherence on outcomes in ER-low BC.

Main Methods:

  • Analysis of real-world data from the Neo-Real/GBECAM-0123 study.
  • Inclusion of 20 patients with ER-low BC treated with neoadjuvant P+CT since July 2020.
  • Evaluation of pathologic complete response (pCR) as the primary endpoint.

Main Results:

  • A pCR rate of 60% was observed in the 20 analyzed ER-low BC patients.
  • Most patients had grade 3 tumors (90%) and stage II disease (70%).
  • Fewer than 6 cycles of pembrolizumab were associated with a trend towards lower pCR rates (20% vs 73.3%).

Conclusions:

  • ER-low BC exhibits clinicopathological features and treatment responses similar to TNBC.
  • Neoadjuvant P+CT is a viable treatment option for stage II-III ER-low/HER2- BC, aligning with TNBC standards.
  • Adherence to the complete P+CT regimen is important for maximizing treatment effectiveness in ER-low BC.