{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T11:56:29Z","timestamp":1776254189347,"version":"3.50.1"},"reference-count":27,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T00:00:00Z","timestamp":1776211200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Neoadjuvant systemic therapy incorporating dual HER2 blockade has significantly improved outcomes in patients with HER2-positive breast cancer. Pathological complete response (pCR) is an important surrogate endpoint associated with improved long-term survival. However, substantial heterogeneity in treatment response persists, and identifying factors associated with pCR remains clinically relevant. In addition to established clinicopathological variables, systemic inflammation-based biomarkers have recently been investigated as potential predictors of treatment response. Materials and Methods: In this multicenter retrospective study, we evaluated patients with stage II\u2013III HER2-positive breast cancer who received pertuzumab-based neoadjuvant therapy followed by surgery between January 2023 and June 2025 across six oncology centers in T\u00fcrkiye. Clinicopathological characteristics, treatment-related variables, and baseline systemic inflammation-based biomarkers were analyzed. Logistic regression analyses were performed to identify factors associated with pCR. Results: A total of 372 patients were included, and the overall pCR rate was 61%. Higher pCR rates were observed in patients with hormone receptor-negative tumors (71.4% vs. 54.3%, p = 0.001) and in premenopausal patients (68.7% vs. 53.4%, p = 0.003). In multivariate analysis, hormone receptor status (OR 2.25, 95% CI 1.41\u20133.60, p &lt; 0.001), menopausal status (OR 1.90, 95% CI 1.22\u20132.94, p = 0.005), neoadjuvant treatment regimen (OR 2.15, 95% CI 1.05\u20134.41, p = 0.037), and perineural invasion (OR 2.61, 95% CI 1.10\u20136.22, p = 0.030) were independently associated with pCR. In contrast, systemic inflammation-based biomarkers did not demonstrate significant associations with pCR, and ROC analyses showed limited discriminatory ability (AUC values approximately 0.5). Conclusions: In patients with HER2-positive breast cancer treated with pertuzumab-based neoadjuvant therapy, treatment response appears to be primarily influenced by clinicopathological and treatment-related factors rather than systemic inflammatory status. Peripheral blood inflammatory biomarkers derived from routine laboratory parameters showed limited value in predicting pCR in this setting.<\/jats:p>","DOI":"10.3390\/medicina62040763","type":"journal-article","created":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T10:30:23Z","timestamp":1776249023000},"page":"763","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinicopathological Predictors of Pathological Complete Response in HER2-Positive Breast Cancer Treated with Pertuzumab-Based Neoadjuvant Therapy: A Multicenter Real-World Study"],"prefix":"10.3390","volume":"62","author":[{"given":"Fatih","family":"Y\u0131ld\u0131z","sequence":"first","affiliation":[{"name":"Department of Medical Oncology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara 06200, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5357-7610","authenticated-orcid":false,"given":"Berkan","family":"Karabuga","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara 06200, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4237-1606","authenticated-orcid":false,"given":"Salih","family":"Karatl\u0131","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Ankara Etlik City Hospital, Ankara 06170, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Merve","family":"Yal\u0131nk\u0131l\u0131\u00e7","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara 06200, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9884-5789","authenticated-orcid":false,"given":"\u0130lknur","family":"Deliktas Onur","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara 06200, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ece","family":"Bilgic Koylu","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Ankara University Faculty of Medicine, Ankara 06050, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S\u0131la","family":"Soylu Koco\u011flu","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Gazi University Faculty of Medicine, Ankara 06560, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emrah","family":"Eraslan","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara 06200, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0333-1388","authenticated-orcid":false,"given":"Ayseg\u00fcl","family":"Ilhan G\u00fclesen","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Ankara Etlik City Hospital, Ankara 06170, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erkan","family":"Erdur","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Medical Oncology, Gazi Ya\u015fargil Training and Research Hospital, Diyarbakir 21070, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4139-067X","authenticated-orcid":false,"given":"Ozgen Ahmet","family":"Yildirim","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Ankara Etlik City Hospital, Ankara 06170, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0023-5793","authenticated-orcid":false,"given":"Fatih","family":"Gurler","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Gazi University Faculty of Medicine, Ankara 06560, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0545-1383","authenticated-orcid":false,"given":"Hatime Arzu","family":"Yasar","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Ankara University Faculty of Medicine, Ankara 06050, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9153-6921","authenticated-orcid":false,"given":"Ferit","family":"Aslan","sequence":"additional","affiliation":[{"name":"Medical Oncology, Y\u00fcksek \u0130htisas University Affiliated Medicalpark Ankara Bat\u0131kent Hospital, Ankara 06370, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,15]]},"reference":[{"key":"ref_1","first-page":"229","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA Cancer J. 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