{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T06:27:34Z","timestamp":1791959254282,"version":"4.3.4"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T00:00:00Z","timestamp":1752019200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Trastuzumab emtansine (T-DM1) is widely used for treating both early and advanced HER2-positive breast cancer in China. Thrombocytopenia represents a major adverse event associated with T-DM1 during anti-tumor therapy. Therefore, further exploration is needed to predict and mitigate T-DM1-induced platelet count decrease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>We conducted a retrospective study utilizing electronic medical records from a single breast cancer center in Henan province. Clinicopathological characteristics and consecutive laboratory examination data were collected for all patients. A total of 63 patients treated with T-DM1 were categorized into two groups: Thrombocytopenia and Non-thrombocytopenia. Statistical analyses employed Chi-squared\/Fishers exact test, F-test\/Kruskal\u2013Wallis test, logistic regression, and Kaplan\u2013Meier methods.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 63 HER2-positive patients receiving adjuvant T-DM1 were enrolled. A comparison between groups showed that patients in the Thrombocytopenia group were more frequently postmenopausal, had lymph node metastasis, and had undergone radiotherapy. Postmenopausal status was identified as a risk factor for T-DM1-induced thrombocytopenia. Grade \u22652 thrombocytopenia occurred in 30 patients (47.6%) and grade \u22653 thrombocytopenia occurred in 16 patients (25.4%). Patients treated with rhIL-1 1(recombinant human interleukin-11) or rhTPO (recombinant human thrombopoietin) required a longer time for platelet (PLT) recovery to \u226575 \u00d7 10<jats:sup>9<\/jats:sup>\/L and \u2265100 \u00d7 10<jats:sup>9<\/jats:sup>\/L compared to those receiving TPO-Ras (thrombopoietin receptor agonists), although this difference was not statistically significant. The estimated 1-year invasive disease-free survival (IDFS) for all T-DM1-treated patients was 96.8%. The 1-year IDFS rates for the Thrombocytopenia and Non-thrombocytopenia groups were 100.0% and 93.9%, respectively, with no statistically significant difference observed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our findings indicate that T-DM1-induced thrombocytopenia was manageable in this cohort of breast cancer patients. Postmenopausal status correlated with an increased risk of platelet count decrease. Different platelet-producing drugs demonstrated comparable effectiveness in managing thrombocytopenia.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fonc.2025.1592440","type":"journal-article","created":{"date-parts":[[2025,7,10]],"date-time":"2025-07-10T05:43:22Z","timestamp":1752126202000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Clinical characteristics, treatment, and survival of thrombocytopenia induced by T-DM1 in early HER2-positive breast cancer"],"prefix":"10.3389","volume":"15","author":[{"given":"Fang","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaosan","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiuchun","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenzhen","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,7,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660","article-title":"Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA: Cancer J Clin"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp058197","article-title":"The distinctive nature of HER2-positive breast cancers","volume":"353","author":"Burstein","year":"2005","journal-title":"New Engl J Med"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(17)30312-1","article-title":"Trastuzumab emtansine versus capecitabine plus lapatinib in patients with previously treated HER2-positive advanced breast cancer (EMILIA): a descriptive analysis of final overall survival results from a randomised, open-label, phase 3 trial","volume":"18","author":"Di\u00e9ras","year":"2017","journal-title":"Lancet Oncol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"51","DOI":"10.2147\/CE.S217848","article-title":"Pertuzumab in the treatment of HER2-positive breast cancer: an evidence-based review of its safety, efficacy, and place in therapy","volume":"14","author":"Ishii","year":"2019","journal-title":"Core evidence."},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-020-01281-4","article-title":"Trastuzumab deruxtecan: first approval","volume":"80","author":"Keam","year":"2020","journal-title":"Drugs."},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(19)30863-0","article-title":"Pertuzumab, trastuzumab, and docetaxel for HER2-positive metastatic breast cancer (CLEOPATRA): end-of-study results from a double-blind, randomised, placebo-controlled, phase 3 study","volume":"21","author":"Swain","year":"2020","journal-title":"Lancet Oncol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1021\/ar700108g","article-title":"Targeted cancer therapy: conferring specificity to cytotoxic drugs","volume":"41","author":"Chari","year":"2008","journal-title":"Accounts Chem Res"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2010.31.6679","article-title":"Trastuzumab-DM1: building a chemotherapy-free road in the treatment of human epidermal growth factor receptor 2-positive breast cancer","volume":"29","author":"Isakoff","year":"2011","journal-title":"J Clin oncology: Off J Am Soc Clin Oncol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(14)70178-0","article-title":"Trastuzumab emtansine versus treatment of physician\u2019s choice for pretreated HER2-positive advanced breast cancer (TH3RESA): a randomised, open-label, phase 3 trial","volume":"15","author":"Krop","year":"2014","journal-title":"Lancet Oncol"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-19-3980","article-title":"FDA approval summary: ado-trastuzumab emtansine for the adjuvant treatment of HER2-positive early breast cancer","volume":"26","author":"Wedam","year":"2020","journal-title":"Clin Cancer research: an Off J Am Assoc Cancer Res"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(17)30313-3","article-title":"Trastuzumab emtansine versus treatment of physician\u2019s choice in patients with previously treated HER2-positive metastatic breast cancer (TH3RESA): final overall survival results from a randomised open-label phase 3 trial","volume":"18","author":"Krop","year":"2017","journal-title":"Lancet Oncol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1016\/j.ejca.2018.12.022","article-title":"Safety of trastuzumab emtansine (T-DM1) in patients with HER2-positive advanced breast cancer: Primary results from the KAMILLA study cohort 1","volume":"109","author":"Montemurro","year":"2019","journal-title":"Eur J Cancer (Oxford England: 1990)."},{"key":"B13","doi-asserted-by":"publisher","first-page":"110407","DOI":"10.1016\/j.biopha.2020.110407","article-title":"T-DM1-induced thrombocytopenia in breast cancer patients: New perspectives","volume":"129","author":"Liu","year":"2020","journal-title":"Biomedicine pharmacotherapy = Biomedecine pharmacotherapie."},{"key":"B14","doi-asserted-by":"publisher","first-page":"1139","DOI":"10.21037\/atm-21-2763","article-title":"Assessment of racial differences in the incidence of thrombocytopenia induced by trastuzumab emtansine: a systematic review and meta-analysis","volume":"9","author":"Zhang","year":"2021","journal-title":"Ann Trans Med"},{"key":"B15","volume-title":"Common terminology criteria for adverse events (CTCAE) version 5.0","year":"2017"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1209124","article-title":"Trastuzumab emtansine for HER2-positive advanced breast cancer","volume":"367","author":"Verma","year":"2012","journal-title":"New Engl J Med"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2013.54.4999","article-title":"Trastuzumab emtansine in human epidermal growth factor receptor 2-positive metastatic breast cancer: an integrated safety analysis","volume":"32","author":"Di\u00e9ras","year":"2014","journal-title":"J Clin oncology: Off J Am Soc Clin Oncol"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2024.1383279","article-title":"Efficacy and safety of Trastuzumab Emtansine in treating human epidermal growth factor receptor 2-positive metastatic breast cancer in Chinese population: a real-world multicenter study","volume":"11","author":"He","year":"2024","journal-title":"Front Med"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2021.04.011","article-title":"Adjuvant T-DM1 versus trastuzumab in patients with residual invasive disease after neoadjuvant therapy for HER2-positive breast cancer: subgroup analyses from KATHERINE","volume":"32","author":"Mamounas","year":"2021","journal-title":"Ann oncology: Off J Eur Soc Med Oncol"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1016\/j.clbc.2019.10.001","article-title":"Predicting thrombocytopenia in patients with breast cancer treated with ado-trastuzumab emtansine","volume":"20","author":"Modi","year":"2020","journal-title":"Clin Breast cancer."},{"key":"B21","doi-asserted-by":"publisher","first-page":"100188","DOI":"10.1016\/j.ctarc.2020.100188","article-title":"Safety and efficacy of T-DM1 in patients with advanced HER2-positive breast cancer The Royal Marsden experience","volume":"24","author":"Battisti","year":"2020","journal-title":"Cancer Treat Res Commun"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1814017","article-title":"Trastuzumab emtansine for residual invasive HER2-positive breast cancer","volume":"380","author":"von Minckwitz","year":"2019","journal-title":"New Engl J Med"},{"key":"B23","doi-asserted-by":"publisher","first-page":"523","DOI":"10.3892\/ol.2023.14110","article-title":"Early thrombocytopenia predicts longer time\u2212to\u2212treatment discontinuation in trastuzumab emtansine treatment","volume":"26","author":"Sahin","year":"2023","journal-title":"Oncol letters."},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.35292","article-title":"A real-world observation on thrombopoietic agents for patients with cancer treatment-induced thrombocytopenia in China: A multicenter, cross-sectional study","volume":"130","author":"Chen","year":"2024","journal-title":"Cancer."},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2024.1288964","article-title":"Effectiveness and economic evaluation of rhTPO and rhIL-11 in the treatment of cancer therapy induced thrombocytopenia based on real-world research","volume":"15","author":"Gong","year":"2024","journal-title":"Front Pharmacol"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.19.00882","article-title":"Neoadjuvant trastuzumab emtansine and pertuzumab in human epidermal growth factor receptor 2-positive breast cancer: three-year outcomes from the phase III KRISTINE study","volume":"37","author":"Hurvitz","year":"2019","journal-title":"J Clin oncology: Off J Am Soc Clin Oncol"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.23.02170","article-title":"Adjuvant trastuzumab emtansine versus paclitaxel plus trastuzumab for stage I human epidermal growth factor receptor 2-positive breast cancer: 5-year results and correlative analyses from ATEMPT","volume":"42","author":"Tarantino","year":"2024","journal-title":"J Clin oncology: Off J Am Soc Clin Oncol"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2025.1592440\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,10]],"date-time":"2025-07-10T13:39:00Z","timestamp":1752154740000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2025.1592440\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,9]]},"references-count":27,"alternative-id":["10.3389\/fonc.2025.1592440"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2025.1592440","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,9]]},"article-number":"1592440"}}