{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T02:51:54Z","timestamp":1791427914526,"version":"4.3.3"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Real-world comparative data on the safety of adjuvant trastuzumab emtansine (T-DM1) vs trastuzumab with concurrent radiotherapy (RT) in HER2-positive early breast cancer (BC) remain limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective, multicenter study, we included 133 patients with HER2-positive early-stage BC treated with neoadjuvant therapy, surgery, and adjuvant systemic therapy administered concurrently with RT at 4 hospitals. Patients received adjuvant T-DM1 (n\u2009=\u200950) if residual disease was present, or trastuzumab (n\u2009=\u200983) if a pathologic complete response was achieved. Toxicities were graded according to CTCAE criteria. A post-hoc power analysis indicated 80% power to detect an absolute between-group difference in toxicity rates of \u2265 25%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The T-DM1 group had poorer performance status, higher nodal stage, and more intensive neoadjuvant regimens. RT parameters were balanced between groups (median dose 50\u2009Gy, 25 fractions; P\u2009&amp;gt;\u2009.05 for all comparisons). T-DM1 was associated with higher rates of thrombocytopenia (70% vs 36.1%, P\u2009&amp;lt;\u2009.001), ALT elevation (20% vs 4.8%, P\u2009=\u2009.008), AST elevation (24.5% vs 2.4%, P\u2009&amp;lt;\u2009.001), and early pulmonary toxicity (48.8% vs 24.1%, P\u2009=\u2009.017), with events predominantly grade 1. In sensitivity analyses adjusting for pertuzumab exposure, T-DM1 associations remained significant for thrombocytopenia (adjusted odds ratio [OR]\u2009=\u20093.85, P\u2009=\u2009.001), ALT elevation (adjusted OR = 4.12, P\u2009=\u2009.026), and early pulmonary toxicity (adjusted OR = 2.64, P\u2009=\u2009.034).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Concurrent adjuvant T-DM1 and RT demonstrated higher but manageable hematologic, hepatic, and pulmonary toxicity compared with trastuzumab. These hypothesis-generating findings require validation in prospective studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/oncolo\/oyag372","type":"journal-article","created":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T18:25:49Z","timestamp":1789755949000},"source":"Crossref","is-referenced-by-count":0,"title":["Comparative safety of concurrent adjuvant trastuzumab emtansine vs trastuzumab with radiotherapy in HER2-positive early breast cancer"],"prefix":"10.1093","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-6030-2563","authenticated-orcid":false,"given":"Mine","family":"Aysan","sequence":"first","affiliation":[{"name":"Department of Medical Oncology, Faculty of Medicine, Medipol University , Istanbul, 34083, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bahadir","family":"Koylu","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Faculty of Medicine, Koc University , Istanbul, 34460, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayberk","family":"Bayramgil","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Umraniye Training and Research Hospital , Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dilek","family":"Unal","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Faculty of Medicine, Medipol University , Istanbul, 34083, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Banu","family":"Karaalio\u011flu","sequence":"additional","affiliation":[{"name":"Department of Radiology, Faculty of Medicine, Medipol University , Istanbul, 34083, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmet","family":"Bilici","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Faculty of Medicine, Medipol University , Istanbul, 34083, 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