Neoadjuvant pembrolizumab plus chemotherapy in older patients with early-stage triple-negative breast cancer: real-world insights from neo-real/GBECAM-0123 - PubMed
4 hours ago
- #geriatric oncology
- #neoadjuvant therapy
- #triple-negative breast cancer
- The KEYNOTE-522 regimen is standard for stage II-III triple-negative breast cancer (TNBC), but older patients were underrepresented in trials.
- A real-world study (Neo-Real/GBECAM-0123) evaluated pembrolizumab plus chemotherapy in TNBC patients aged ≥65 years in Brazil and Argentina.
- Older patients (11% of 724) had distinct baseline features: fewer grade 3 tumors, lower Ki67 ≥50%, fewer BRCA mutations, and more impaired performance status.
- Pathologic complete response (pCR) rate was 54.9% in older vs. 64.5% in younger patients, but age wasn't independently linked to pCR in multivariable analysis.
- Older patients faced higher toxicity: more treatment discontinuations, dose reductions, delays, hospitalizations, and grade ≥3 neutropenia.
- Findings highlight the need for personalized treatment strategies and dedicated research for older TNBC patients due to their unique biology and higher toxicity burden.