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

Abstract 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 respon...

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Main Authors: 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
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Language:English
Published: BMC 2025-05-01
Series:BMC Cancer
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Online Access:https://doi.org/10.1186/s12885-025-14252-3
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author 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
author_facet 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
author_sort Sedat Yıldırım
collection DOAJ
description Abstract 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.
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spelling doaj-art-c2bde1e25d00476081203a28a66e9ca42025-08-20T03:53:22ZengBMCBMC Cancer1471-24072025-05-0125111210.1186/s12885-025-14252-3The 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 analysisSedat Yıldırım0Tugba Başoğlu1Akif Doğan2Goncagul Akdağ3Oguzcan Kınıkoğlu4Alper Topal5Ozkan Alan6Ali Alper Solmaz7Mustafa Gürbüz8Timucin Çil9Rumeysa Çolak10Mesut Yılmaz11Ali Kalem12Nadiye Sever13Nargiz Majıdova14Kubilay Karakoyun15Serhat Sekmek16Omer Saçlı17Melike Ozcelık18Deniz Işık19Heves Surmeli20Ozlem Nuray Sever21Hatice Odabas22Mahmut Emre Yıldırım23Nedim Turan24Department of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science UniversityDepartment of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science UniversityDepartment of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science UniversityDepartment of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science UniversityDepartment of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science UniversityDepartment of Internal Medicine, Division of Medical Oncology, Gulhane Research & Training HospitalDivision of Medical Oncology, School of Medicine, Koç UniversityDepartment of Medical Oncology, Adana City HospitalDepartment of Medical Oncology, Adana City HospitalDepartment of Medical Oncology, Adana City HospitalMedical Oncology Department, Bakırköy Sadi Konuk Training and Research HospitalMedical Oncology Department, Bakırköy Sadi Konuk Training and Research HospitalDepartment of Medical Oncology, School of Medicine, Gaziantep UniversityDepartment of Medical Oncology, School of Medicine, Marmara UniversityDepartment of Medical Oncology, School of Medicine, Marmara UniversityMedical Oncology Department, Ağrı Training and Research HospitalDepartment of Medical Oncology, Ankara City HospitalDepartment of Medical Oncology, University of Health Sciences, Umraniye Training and Research HospitalDepartment of Medical Oncology, University of Health Sciences, Umraniye Training and Research HospitalDepartment of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science UniversityDepartment of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science UniversityDepartment of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science UniversityDepartment of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science UniversityDepartment of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science UniversityDepartment of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science UniversityAbstract 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.https://doi.org/10.1186/s12885-025-14252-3Triple negative breast cancerHER2 statusCarboplatinNeoadjuvant chemotherapyPathologic complete response
spellingShingle 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
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
BMC Cancer
Triple negative breast cancer
HER2 status
Carboplatin
Neoadjuvant chemotherapy
Pathologic complete response
title 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_short 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
title_sort 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
topic Triple negative breast cancer
HER2 status
Carboplatin
Neoadjuvant chemotherapy
Pathologic complete response
url https://doi.org/10.1186/s12885-025-14252-3
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