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BACKGROUND: Sentinel lymph node biopsy (SLNB) is the standard procedure for axillary staging in early breast cancer. Although the radioisotope (RI) method is highly accurate, it requires nuclear medicine facilities and exposes patients to radiation. Superparamagnetic iron oxide (SPIO) tracers were shown to be noninferior to RI in trials outside Japan but are not approved in Japan. Resovist (ferucarbotran), an MRI contrast agent containing SPIO, may be an alternative. This study compared the feasibility and diagnostic performance of Resovist-based magnetic SLNB with the RI method. METHODS: This paired study analyzed 27 breast cancer cases treated with both RI-based and Resovist-based magnetic SLNB. Resovist 0.8 mL was injected subcutaneously above the tumor or into the periareolar region, and the site was gently massaged. The injection-site skin and subcutaneous tissue were excised to prevent pigmentation. Identification rates were assessed at the patient and node levels, and subgroup analysis of patients stratified by body mass index (BMI <25 vs. ≥25) was performed. McNemar's and Fisher's exact tests were used. RESULTS: SLN identification was 100% (27/27 patients) for RI and 88.9% (24/27) for the magnetic method. Among 49 nodes, the results were RI+/Mag+ for 34, RI+/Mag- for 6, and RI-/Mag+ for 9, yielding detection rates of 81.6% (RI) and 87.8% (magnetic). No allergic reactions, pigmentation, or injection site complications occurred. BMI had no significant effect (p > 0.05). CONCLUSIONS: Resovist-based magnetic SLNB was feasible and safe, and had detection rates comparable to those of RI. Optimization of injection conditions may further improve accuracy.

DOI： 10.1272/jnms.JNMS.2026_93-113

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BACKGROUND: Subcutaneous pertuzumab and trastuzumab with hyaluronidase (PHESGO®) shorten chair time versus intravenous dual HER2 blockade, but real-world Asian data are scarce. METHODS: We retrospectively reviewed 47 Asian patients with HER2-positive breast cancer treated with PHESGO® (January 2024-July 2025) across neoadjuvant, adjuvant, and metastatic settings. The primary endpoint was pathological complete response (pCR) in the neoadjuvant cohort; secondary endpoints included sequencing, safety, and metastatic activity. RESULTS: Median age was 65 years. In the neoadjuvant cohort (n = 26), pCR was 65% (17/26). PHESGO®-first regimens achieved higher pCR than anthracycline-first regimens (85.7% vs. 41.7%; p = 0.038). Treatment was generally well tolerated: the most frequent events were dysgeusia (57%), diarrhea (38%), and rash (34%), mostly grade 1-2; one grade ≥3 event (thrombocytopenia) occurred, and no symptomatic cardiac dysfunction was observed. Adverse event profiles were broadly comparable in patients ≥ 70 versus <70 years. In metastatic disease (n = 10), objective response and disease control rates were 56% and 78%, respectively. CONCLUSIONS: In routine practice, PHESGO® showed substantial neoadjuvant activity, acceptable toxicity, and workflow advantages. Early use of subcutaneous dual HER2 blockade with taxane may enhance pCR and facilitate delivery; prospective validation is warranted.

DOI： 10.3390/curroncol32120658

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Backgrounds: Programmed death-ligand 1 (PD-L1) immunohistochemistry (IHC) is a critical predictive biomarker for immune checkpoint inhibitor (ICI) therapy in triple-negative breast cancer (TNBC). However, prolonged storage of formalin-fixed paraffin-embedded (FFPE) tissue may reduce antigenicity, potentially leading to false-negative results. False-negative results may lead to the inappropriate selection of ICI therapy. We investigated the effect of FFPE storage duration on PD-L1 immunoreactivity. Methods: We retrospectively analyzed 63 TNBC cases with PD-L1 testing using the 22C3 pharmDx assay at diagnosis and repeated IHC on the same FFPE blocks after varying storage durations (<1, 1-2, 2-3, ≥3 years). PD-L1 positivity was defined as Combined Positive Score (CPS) ≥ 10. Associations with clinicopathologic features, pathologic complete response (pCR) after neoadjuvant chemotherapy (NAC), and survival were evaluated. Results: At diagnosis, 41 patients (65.1%) were PD-L1-positive. In the PD-L1-positive group, decreased staining was observed in 0%, 11%, 13%, and 50% of cases for <1, 1-2, 2-3, and ≥3 years of storage, respectively (p = 0.015). PD-L1 positivity correlated with higher Ki67 and nuclear grade. pCR was achieved in 33% of PD-L1-positive vs. 0% of PD-L1-negative NAC patients (p = 0.0527). Survival analysis showed a non-significant trend toward shorter recurrence-free and overall survival in PD-L1-positive patients. Conclusions: Prolonged FFPE storage, particularly beyond three years, significantly reduces PD-L1 immunoreactivity. Testing on recent specimens is recommended to avoid false-negative results that may impact ICI eligibility.

DOI： 10.3390/cancers17193103

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Dose-dense chemotherapy shortens the interval between chemotherapy cycles and has shown improved outcomes in high-risk breast cancer patients. We retrospectively evaluated the efficacy and safety of dose-dense chemotherapy in 80 breast cancer patients treated at our hospital from 2020 to 2024. The regimen included epirubicin and cyclophosphamide followed by paclitaxel or docetaxel, with pegfilgrastim support. The overall treatment completion rate was 82.5%. Of the 80 patients, 55 underwent neoadjuvant chemotherapy, and the pathological complete response rate was significantly higher in triple-negative breast cancer (59.1%) compared to that in luminal-type cancer (9.1%). Common adverse events included anemia, liver dysfunction, myalgia, and peripheral neuropathy. Febrile neutropenia occurred in 8.8% of patients, with some cases linked to pegfilgrastim body pod use, particularly in individuals with low subcutaneous fat. Notably, two patients developed pneumocystis pneumonia, potentially associated with steroid administration. Despite these toxicities, most were manageable and resolved after treatment. Our findings support the efficacy of dose-dense chemotherapy, particularly in triple-negative breast cancer, while highlighting the importance of individualized supportive care and vigilance regarding hematologic and infectious complications.

DOI： 10.3390/curroncol32080441

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BACKGROUND: Cyclin-dependent kinase 4/6 (CDK4/6) inhibitors have transformed the management of hormone receptor-positive/HER2-negative (HR+/HER2-) advanced breast cancer, yet evidence for elderly or poor-performance patients remains limited. This study examined real-world outcomes of palbociclib plus endocrine therapy in Asian patients, with additional subgroup analyses by age and performance status. METHODS: We retrospectively analyzed 46 consecutive Asian patients with recurrent or de novo HR+/HER2- breast cancer treated with first-line palbociclib plus ET between April 2021 and March 2025. The primary endpoint was progression-free survival (PFS). Secondary endpoints included overall response rate (ORR), disease control rate (DCR), and safety. Subgroup analyses were performed by age (<70 vs. ≥70 years) and performance status (PS; 0-1 vs. 2-3). RESULTS: The median PFS was 26.6 months (range, 1.4-69.5). Stratified by age, median PFS was 26.9 months in patients <70 years and 26.2 months in those ≥70 years (p = 0.760). By PS, PFS was 26.9 months for PS 0-1 and 17.8 months for PS 2-3 (p = 0.099). ORR was 60.9% and DCR 93.5%; notably, all PS 2-3 patients achieved disease control. Hematologic toxicities were common, with neutropenia (80.4%) and leukopenia (86.7%) predominating, but grade ≥ 3 anemia was rare (2.2%). Elderly patients experienced anemia more frequently, while overall toxicity remained manageable. Dose reductions occurred in 47.8% without loss of efficacy. CONCLUSIONS: In routine Japanese practice, palbociclib plus ET provided prolonged PFS and high disease control consistent with pivotal trials and international real-world evidence. Importantly, elderly patients tolerated treatment well, and selected PS 2-3 patients also derived clinical benefit. These findings indicate that neither age nor PS alone should preclude the use of palbociclib in carefully monitored real-world patients.

DOI： 10.32604/or.2025.073891

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Language：Japanese   Publisher：(一社)日本乳癌学会  

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Language：Japanese   Publisher：(一社)日本乳癌学会  

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Language：Japanese   Publisher：(一社)日本乳癌学会  

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Language：English   Publisher：(一社)日本癌治療学会  

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Language：Japanese   Publisher：(一社)日本乳癌学会  

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