Comparison of T-DM1 and trastuzumab-pertuzumab in HER2-positive breast cancer patients with residual disease after neoadjuvant therapy: a retrospective study
Abstract Background For HER2-positive early-stage breast cancer patients who have received neoadjuvant chemotherapy with trastuzumab and pertuzumab (HP), it remains unclear whether to intensify treatment with T-DM1 or to continue with HP therapy in the presence of residual disease identified in post...
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BMC
2025-07-01
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| Series: | World Journal of Surgical Oncology |
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| Online Access: | https://doi.org/10.1186/s12957-025-03909-9 |
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| author | Junxiao Wang Yushuai Yu Qisheng Lin Xin Wang |
| author_facet | Junxiao Wang Yushuai Yu Qisheng Lin Xin Wang |
| author_sort | Junxiao Wang |
| collection | DOAJ |
| description | Abstract Background For HER2-positive early-stage breast cancer patients who have received neoadjuvant chemotherapy with trastuzumab and pertuzumab (HP), it remains unclear whether to intensify treatment with T-DM1 or to continue with HP therapy in the presence of residual disease identified in postoperative pathology. Methods This retrospective study included patients at two cancer centers in China from January 2020 to August 2022. Patients were subsequently treated with either continued HP or intensified therapy with T-DM1 for one year. A multivariable Cox proportional hazards regression model was used to identify factors influencing patient outcomes. Propensity score matching(PSM) was employed to mitigate the impact of confounding variables, and disease-free survival(DFS) between the T-DM1 and HP groups was compared. Results Before PSM, 114 patients were included, with 24 in the T-DM1 group and 90 in the HP group. Multivariate analysis revealed that patients in ypStage I/II had a higher DFS than those in ypStage III. In the T-DM1 group, 14 patients (58.3%) experienced thrombocytopenia, with 12 affected during cycles 2 to 4. After PSM, no statistically significant difference in DFS between the two groups (P = 0.48). The 1, 2, and 3-year DFS rates for the T-DM1 group were 94.7%, 94.7%, and 94.7%, respectively, while for the HP group, they were 100%,100%, and 89.5%. Conclusions In patients with HER2-positive early breast cancer who have residual disease after receiving neoadjuvant treatment with HP, the continued administration of HP can achieve therapeutic effects comparable to those of T-DM1, without significant complications. |
| format | Article |
| id | doaj-art-5b64b7895162427c82404de7a089c3ca |
| institution | Kabale University |
| issn | 1477-7819 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Surgical Oncology |
| spelling | doaj-art-5b64b7895162427c82404de7a089c3ca2025-08-20T03:38:18ZengBMCWorld Journal of Surgical Oncology1477-78192025-07-012311910.1186/s12957-025-03909-9Comparison of T-DM1 and trastuzumab-pertuzumab in HER2-positive breast cancer patients with residual disease after neoadjuvant therapy: a retrospective studyJunxiao Wang0Yushuai Yu1Qisheng Lin2Xin Wang3Department of Thyroid and Breast Surgery, The Fifth Clinical Medical College of Fujian University of Traditional Chinese Medicine, The Second Hospital of SanmingDepartment of Breast Surgery, Clinical Oncology School of Fujian Medical University, Fujian Cancer HospitalDepartment of Thyroid and Breast Surgery, The Fifth Clinical Medical College of Fujian University of Traditional Chinese Medicine, The Second Hospital of SanmingThe First Department of Breast Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, National Clinical Research Center for Cancer, Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical UniversityAbstract Background For HER2-positive early-stage breast cancer patients who have received neoadjuvant chemotherapy with trastuzumab and pertuzumab (HP), it remains unclear whether to intensify treatment with T-DM1 or to continue with HP therapy in the presence of residual disease identified in postoperative pathology. Methods This retrospective study included patients at two cancer centers in China from January 2020 to August 2022. Patients were subsequently treated with either continued HP or intensified therapy with T-DM1 for one year. A multivariable Cox proportional hazards regression model was used to identify factors influencing patient outcomes. Propensity score matching(PSM) was employed to mitigate the impact of confounding variables, and disease-free survival(DFS) between the T-DM1 and HP groups was compared. Results Before PSM, 114 patients were included, with 24 in the T-DM1 group and 90 in the HP group. Multivariate analysis revealed that patients in ypStage I/II had a higher DFS than those in ypStage III. In the T-DM1 group, 14 patients (58.3%) experienced thrombocytopenia, with 12 affected during cycles 2 to 4. After PSM, no statistically significant difference in DFS between the two groups (P = 0.48). The 1, 2, and 3-year DFS rates for the T-DM1 group were 94.7%, 94.7%, and 94.7%, respectively, while for the HP group, they were 100%,100%, and 89.5%. Conclusions In patients with HER2-positive early breast cancer who have residual disease after receiving neoadjuvant treatment with HP, the continued administration of HP can achieve therapeutic effects comparable to those of T-DM1, without significant complications.https://doi.org/10.1186/s12957-025-03909-9Trastuzumab emtansineHER2-positiveEarly breast CancerTrastuzumabPertuzumab |
| spellingShingle | Junxiao Wang Yushuai Yu Qisheng Lin Xin Wang Comparison of T-DM1 and trastuzumab-pertuzumab in HER2-positive breast cancer patients with residual disease after neoadjuvant therapy: a retrospective study World Journal of Surgical Oncology Trastuzumab emtansine HER2-positive Early breast Cancer Trastuzumab Pertuzumab |
| title | Comparison of T-DM1 and trastuzumab-pertuzumab in HER2-positive breast cancer patients with residual disease after neoadjuvant therapy: a retrospective study |
| title_full | Comparison of T-DM1 and trastuzumab-pertuzumab in HER2-positive breast cancer patients with residual disease after neoadjuvant therapy: a retrospective study |
| title_fullStr | Comparison of T-DM1 and trastuzumab-pertuzumab in HER2-positive breast cancer patients with residual disease after neoadjuvant therapy: a retrospective study |
| title_full_unstemmed | Comparison of T-DM1 and trastuzumab-pertuzumab in HER2-positive breast cancer patients with residual disease after neoadjuvant therapy: a retrospective study |
| title_short | Comparison of T-DM1 and trastuzumab-pertuzumab in HER2-positive breast cancer patients with residual disease after neoadjuvant therapy: a retrospective study |
| title_sort | comparison of t dm1 and trastuzumab pertuzumab in her2 positive breast cancer patients with residual disease after neoadjuvant therapy a retrospective study |
| topic | Trastuzumab emtansine HER2-positive Early breast Cancer Trastuzumab Pertuzumab |
| url | https://doi.org/10.1186/s12957-025-03909-9 |
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