International Journal of Hematology and Oncology
2025, Vol 35, Num 3 Page(s): 178-185
| Back | Table of Contents | PDF | Mail to Author | |
Real-World Pathologic Complete Response Rates with Neoadjuvant Pembrolizumab in Stage II–III Triple-Negative Breast Cancer: Impact of Ki-67 Proliferation Index
Gokhan SAHIN1, Oguzcan OZKAN1, Caner ACAR1, Haydar Cagatay YUKSEL1, Sercan ON1, Hasan Cagri YILDIRIM1, Burcu CAKAR1, Erhan GOKMEN1
Ege University, Faculty of Medicine, Department of Medical Oncology
Keywords: Triple-negative breast cancer, Neoadjuvant chemotherapy, Pembrolizumab, Pathologic complete response, Ki-67
The addition of immunotherapy to neoadjuvant chemotherapy (NAC) has shown promising efficacy in early-stage triple-negative breast cancer (TNBC), particularly in achieving pathologic complete response (pCR). However, real-world data remain limited. This study aimed to evaluate pCR rates and potential predictive factors in a real-world cohort of patients with stage II–III TNBC receiving neoadjuvant pembrolizumab-based chemotherapy. We retrospectively analyzed 4 4 TNBC patients treated at Ege University between 2022–2024. All received pembrolizumab plus taxane- and anthracycline-based NAC. Clinical and pathological variables, including Ki-67 index, were analyzed for associations with pCR. The overall pCR rate was 56.8%, which is broadly comparable to real-world reports but slightly lower than clinical trials. No standard clinicopathologic variable, including age, stage, histology, or nodal status, significantly predicted pCR. While conventional Ki-67 cut-offs (≥ 30% or median) were not predictive, a ROC-derived threshold of ≥ 75% was significantly associated with higher pCR rates (OR 5.67; p= 0.042), although its discriminative ability was limited (AUC= 0.598). Neoadjuvant pembrolizumab yields pCR rates comparable to real-world reports but modestly lower than clinical trial outcomes. Extremely high Ki-67 proliferation index (≥ 75%) may help identify responders, though larger studies are warranted for validation.
Gokhan SAHIN1, Oguzcan OZKAN1, Caner ACAR1, Haydar Cagatay YUKSEL1, Sercan ON1, Hasan Cagri YILDIRIM1, Burcu CAKAR1, Erhan GOKMEN1
Ege University, Faculty of Medicine, Department of Medical Oncology
Keywords: Triple-negative breast cancer, Neoadjuvant chemotherapy, Pembrolizumab, Pathologic complete response, Ki-67
The addition of immunotherapy to neoadjuvant chemotherapy (NAC) has shown promising efficacy in early-stage triple-negative breast cancer (TNBC), particularly in achieving pathologic complete response (pCR). However, real-world data remain limited. This study aimed to evaluate pCR rates and potential predictive factors in a real-world cohort of patients with stage II–III TNBC receiving neoadjuvant pembrolizumab-based chemotherapy. We retrospectively analyzed 4 4 TNBC patients treated at Ege University between 2022–2024. All received pembrolizumab plus taxane- and anthracycline-based NAC. Clinical and pathological variables, including Ki-67 index, were analyzed for associations with pCR. The overall pCR rate was 56.8%, which is broadly comparable to real-world reports but slightly lower than clinical trials. No standard clinicopathologic variable, including age, stage, histology, or nodal status, significantly predicted pCR. While conventional Ki-67 cut-offs (≥ 30% or median) were not predictive, a ROC-derived threshold of ≥ 75% was significantly associated with higher pCR rates (OR 5.67; p= 0.042), although its discriminative ability was limited (AUC= 0.598). Neoadjuvant pembrolizumab yields pCR rates comparable to real-world reports but modestly lower than clinical trial outcomes. Extremely high Ki-67 proliferation index (≥ 75%) may help identify responders, though larger studies are warranted for validation.
| Back | Table of Contents | PDF | Mail to Author | |