{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T02:19:06Z","timestamp":1787883546325,"version":"build-2784847793"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2024,4,24]],"date-time":"2024-04-24T00:00:00Z","timestamp":1713916800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,7,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The addition of pembrolizumab (pembro) to neoadjuvant chemotherapy (NAC) is standard of care for the treatment of early triple-negative breast cancer (TNBC) after KEYNOTE-522 trial demonstrated improved pathologic complete response (pCR) rates with the combination. However, the optimal treatment strategy for TNBC remains uncertain as questions persist about which patients benefit from pembro and the best treatment schedule and regimen. We identified real-world clinical characteristics and treatment variables associated with response to NAC plus pembro.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients with early TNBC treated with NAC plus pembro between February 2020 and September 2023 were identified. Univariate and multivariate analysis was performed using logistic regression to identify factors associated with pCR. Cox proportional hazard prediction models were used to identify predictors of invasive disease-free survival and overall survival in this cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A pCR was achieved in 75 (63.6%) of 118 patients. Age at diagnosis (P\u2005=\u2005.04), Ki-67 (P\u2005=\u2005.004), duration from start of pembro to surgery (P\u2005=\u2005.006) and NAC to surgery (P\u2005=\u2005.01), number of cycles of pembro (P\u2005=\u2005.04) and NAC (P\u2005=\u2005.02), and completion of at least 8 cycles of pembro (P\u2005=\u2005.015) and NAC (P\u2005=\u2005.015) were each significantly associated with pCR in univariate analysis. In multivariate analysis, patients younger than 55 years at time of diagnosis (vs age\u2005&amp;gt;\u200555 years) and those completing at least 8 cycles of pembro remained predictive of pCR (OR\u2019s 2.50, 2.49, P\u2005=\u2005.035 and .037, respectively).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this real-world analysis of patients with TNBC treated with NAC plus pembro, younger age and the completion of at least 8 cycles of pembrolizumab were associated with pCR.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/oncolo\/oyae064","type":"journal-article","created":{"date-parts":[[2024,3,27]],"date-time":"2024-03-27T20:30:10Z","timestamp":1711571410000},"page":"566-574","source":"Crossref","is-referenced-by-count":22,"title":["Impact of neoadjuvant pembrolizumab adherence on pathologic complete response in triple-negative breast cancer: a real-world analysis"],"prefix":"10.1093","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9821-8144","authenticated-orcid":false,"given":"Alexis","family":"LeVee","sequence":"first","affiliation":[{"name":"Department of Medical Oncology, City of Hope Comprehensive Cancer Center , Duarte, CA , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, City of Hope Comprehensive Cancer Center , Duarte, CA , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Flores","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, City of Hope Comprehensive Cancer Center , Duarte, CA , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4591-3618","authenticated-orcid":false,"given":"Nora","family":"Ruel","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, City of Hope Comprehensive Cancer Center , Duarte, CA , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"McArthur","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology, UT Southwestern Medical Center , Dallas, TX , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Waisman","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, City of Hope Comprehensive Cancer Center , Duarte, CA , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne","family":"Mortimer","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, City of Hope Comprehensive Cancer Center , Duarte, CA , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,4,24]]},"reference":[{"key":"2024070511383583600_CIT0001","author":"American Cancer Society","year":"2023"},{"key":"2024070511383583600_CIT0002","first-page":"164","article-title":"Pathological complete response and long-term clinical benefit in breast cancer: the CTNeoBC pooled analysis","volume-title":"Lancet","author":"Cortazar","year":"2014"},{"key":"2024070511383583600_CIT0003","first-page":"747","article-title":"Neoadjuvant carboplatin in patients with triple-negative and HER2-positive early breast cancer (GeparSixto; GBG 66): a randomised phase 2 trial","volume-title":"Lancet Oncol","author":"Von Minckwitz","year":"2014"},{"key":"2024070511383583600_CIT0004","first-page":"13","article-title":"Impact of the addition of carboplatin and\/or bevacizumab to neoadjuvant once-per-week paclitaxel followed by dose-dense doxorubicin and cyclophosphamide on pathologic complete response rates in stage II to III triple-negative breast cancer: CALGB 40603 (Alliance)","volume-title":"J Clin Oncol","author":"Sikov","year":"2015"},{"key":"2024070511383583600_CIT0005","first-page":"497","article-title":"Addition of the PARP inhibitor veliparib plus carboplatin or carboplatin alone to standard neoadjuvant chemotherapy in triple-negative breast cancer (BrighTNess): a randomised, phase 3 trial","volume-title":"Lancet Oncol.","author":"Loibl","year":"2018"},{"key":"2024070511383583600_CIT0006","first-page":"387","article-title":"Tumor infiltrating lymphocytes in triple negative breast cancer receiving neoadjuvant chemotherapy","volume-title":"World J Clin Oncol","author":"Castaneda","year":"2016"},{"key":"2024070511383583600_CIT0007","first-page":"361","article-title":"PD-L1 expression in triple-negative breast cancer","volume-title":"Cancer Immunol Res","author":"Mittendorf","year":"2014"},{"key":"2024070511383583600_CIT0008","first-page":"311","article-title":"A comprehensive immunologic portrait of triple-negative breast cancer","volume-title":"Transl Oncol.","author":"Liu","year":"2018"},{"key":"2024070511383583600_CIT0009","first-page":"1817","article-title":"Pembrolizumab plus chemotherapy versus placebo plus chemotherapy for previously untreated locally recurrent inoperable or metastatic triple-negative breast cancer (KEYNOTE-355): a randomised, placebo-controlled, double-blind, phase 3 clinical trial","volume-title":"Lancet.","author":"Cortes","year":"2020"},{"key":"2024070511383583600_CIT0010","first-page":"217","article-title":"Pembrolizumab plus chemotherapy in advanced triple-negative breast cancer","volume-title":"N Engl J Med.","author":"Cortes","year":"2022"},{"key":"2024070511383583600_CIT0011","first-page":"810","article-title":"Pembrolizumab for early triple-negative breast cancer","volume-title":"N Engl J Med.","author":"Schmid","year":"2020"},{"key":"2024070511383583600_CIT0012","first-page":"556","article-title":"Event-free survival with pembrolizumab in early triple-negative breast cancer","volume-title":"N Engl J Med.","author":"Schmid","year":"2022"},{"key":"2024070511383583600_CIT0013","first-page":"534","article-title":"Pathologic complete response (pCR) to neoadjuvant treatment with or without atezolizumab in triple-negative, early high-risk and locally advanced breast cancer: NeoTRIP Michelangelo randomized study\u2606","volume-title":"Ann Oncol","author":"Gianni","year":"2022"},{"key":"2024070511383583600_CIT0014","first-page":"1090","article-title":"Neoadjuvant atezolizumab in combination with sequential nab-paclitaxel and anthracycline-based chemotherapy versus placebo and chemotherapy in patients with early-stage triple-negative breast cancer (IMpassion031): a randomised, double-blind, phase 3 trial","volume-title":"Lancet","author":"Mittendorf","year":"2020"},{"key":"2024070511383583600_CIT0015","first-page":"1149","article-title":"Neoadjuvant durvalumab improves survival in early triple-negative breast cancer independent of pathological complete response\u2606","volume-title":"Ann Oncol.","author":"Loibl","year":"2022"},{"key":"2024070511383583600_CIT0016","author":"National Comprehensive Cancer Network"},{"key":"2024070511383583600_CIT0017","first-page":"676","article-title":"Effect of pembrolizumab plus neoadjuvant chemotherapy on pathologic complete response in women with early-stage breast cancer: an analysis of the ongoing phase 2 adaptively randomized I-SPY2 trial","volume-title":"JAMA Oncol","author":"Nanda","year":"2020"},{"key":"2024070511383583600_CIT0018","first-page":"377","article-title":"Outcome after neoadjuvant chemotherapy in young breast cancer patients: a pooled analysis of individual patient data from 8 prospectively randomized controlled trials","volume-title":"Breast Cancer Res Treat.","author":"Loibl","year":"2015"},{"key":"2024070511383583600_CIT0019","first-page":"e233329","article-title":"Racial disparities in pathological complete response among patients receiving neoadjuvant chemotherapy for early-stage breast cancer","volume-title":"JAMA Netw Open","author":"Zhao","year":"2023"},{"key":"2024070511383583600_CIT0020","first-page":"729","article-title":"Estrogen receptor (ER) mRNA and ER-related gene expression in breast cancers that are 1% to 10% ER-positive by immunohistochemistry","volume-title":"J Clin Oncol.","author":"Iwamoto","year":"2012"},{"key":"2024070511383583600_CIT0021","first-page":"533","article-title":"PAM50 for prediction of response to neoadjuvant chemotherapy for ER-positive breast cancer","volume-title":"Breast Cancer Res Treat.","author":"Ohara","year":"2019"},{"key":"2024070511383583600_CIT0022","first-page":"34","article-title":"Low Estrogen Receptor (ER)-positive breast cancer and neoadjuvant systemic chemotherapy: is response similar to typical ER-positive or ER-negative disease","volume-title":"Am J Clin Pathol.","author":"Landmann","year":"2018"},{"key":"2024070511383583600_CIT0023","first-page":"101","article-title":"Impact of estrogen receptor levels on outcome in non-metastatic triple negative breast cancer patients treated with neoadjuvant\/adjuvant chemotherapy","volume-title":"NPJ Breast Cancer.","author":"Dieci","year":"2021"},{"key":"2024070511383583600_CIT0024","doi-asserted-by":"crossref","article-title":"Phase 3 study of neoadjuvant pembrolizumab or placebo plus chemotherapy, followed by adjuvant pembrolizumab or placebo plus endocrine therapy for early-stage high-risk ER+\/HER2\u2212 breast cancer: KEYNOTE-756","author":"Cardoso","DOI":"10.1158\/1538-7445.SABCS23-GS01-02"},{"key":"2024070511383583600_CIT0025","first-page":"S1257","article-title":"Pembrolizumab or placebo plus chemotherapy followed by pembrolizumab or placebo for early-stage TNBC: updated EFS results from the phase III KEYNOTE-522 study","volume-title":"Ann Oncol.","author":"Schmid","year":"2023"},{"key":"2024070511383583600_CIT0026","first-page":"101220","article-title":"Final analysis of the placebo-controlled randomised phase 3 IMpassion031 trial evaluating neoadjuvant atezolizumab (atezo) plus chemotherapy (CT) followed by open-label adjuvant atezo in patients (pts) with early-stage triple-negative breast cancer (eTNBC)","volume-title":"Ann Oncol.","author":"Barrios","year":"2023"}],"container-title":["The 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