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Advances in Neoadjuvant Chemotherapy and Radiotherapy for Breast Cancer: Surgical Impact and Clinical Outcomes

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Dr. Amparo García-Tejedor

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Hospital Universitari de Bellvitge, Barcelona, Spain
Interests: breast cancer

Special Issue Information

Dear Colleagues,

Neoadjuvant chemotherapy (NAC) and radiotherapy (NRT) are essential strategies in the management of locally advanced and high-risk early-stage breast cancer. These therapies facilitate tumor downstaging, enable breast-conserving surgery, and improve patient prognosis. Advances in molecular profiling, targeted therapies, and immunotherapy have further enhanced the efficacy of neoadjuvant regimens, profoundly influencing surgical decisions, postoperative recovery, and personalized care. Despite these advancements, challenges remain in optimizing protocols, minimizing toxicities, and improving quality of life for patients.

We are pleased to invite you to contribute to this Special Issue on "Advances in Neoadjuvant Chemotherapy and Radiotherapy for Breast Cancer: Surgical Impact and Clinical Outcomes." This collection will explore cutting-edge developments in NAC and NRT, focusing on their impact on treatment optimization, surgical strategies (including breast and axillary surgeries), and therapeutic outcomes. Topics will include emerging protocols, the integration of radiotherapy, and the interplay between chemotherapy and radiotherapy in enhancing efficacy.

We welcome original research articles, systematic reviews, and translational studies covering a range of areas, including the following:

Innovative clinical protocols and preclinical findings;
Personalized approaches to neoadjuvant therapies;
Advances in surgical techniques informed by NAC or NRT;
Strategies to overcome challenges in treatment optimization.

This Special Issue aims to provide a comprehensive overview of current trends and future directions in neoadjuvant therapies for breast cancer. We are confident that your expertise in [specific area] will bring valuable insights into this collection and help foster impactful discussions in the field.

Thank you for considering this opportunity. We look forward to receiving your contributions and collaborating with you on this exciting endeavor.

Sincerely,

Dr. Amparo García-Tejedor
Guest Editor

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Research

11 pages, 502 KB

Open AccessArticle

Impact of Chemotherapy Dose Intensity on Pathological Complete Response in Pembrolizumab-Treated Early Triple-Negative Breast Cancer: A Real-World Multicenter Analysis

by Palma Fedele, Stefania Luigia Stucci, Matteo Landriscina, Maria Morritti, Francesco Giuliani, Lucia Moraca, Giuseppe Cairo, Raffaele Ardito, Marianna Giampaglia, Domenico Bilancia, Assunta Melaccio, Antonella Terenzio, Antonio Gnoni, Antonella Licchetta, Federica Fumai, Laura Lanotte, Alessandro Rizzo and Gennaro Gadaleta-Caldarola

Cancers 2025, 17(21), 3554; https://doi.org/10.3390/cancers17213554 - 2 Nov 2025

Cited by 1 | Viewed by 2041

Abstract

Background: Pembrolizumab combined with neoadjuvant chemotherapy significantly improves pCR in early TNBC, but the effect of treatment intensity and baseline clinical factors has been insufficiently explored in real-world settings. Methods: We retrospectively included 169 consecutive patients with stage II–III TNBC treated across 11 Italian oncology centers (January 2022–January 2025) with the KEYNOTE-522 regimen. Clinical, pathological, and treatment data were collected, including relative dose intensity (RDI), dose modifications, and toxicities. The primary endpoint was pCR (ypT0/is ypN0). Results: The overall pCR rate was 65.7%, which is consistent with clinical trial data. Dose reductions occurred in 40% of patients and chemotherapy was discontinued in 18%. Patients maintaining RDI ≥85% achieved higher pCR (79.3% vs. 51.2%, p < 0.001). Similarly, patients without dose reductions (72.5% vs. 55.2%, p = 0.031) and those completing all cycles (73.1% vs. 41.0%, p < 0.001) had superior outcomes. Dose modifications occurred mainly during the taxane/carboplatin phase and were predominantly due to hematological toxicities (anemia 44%, neutropenia 30%, and thrombocytopenia 15%), neuropathy (18%), and gastrointestinal events (36%). Higher TILs correlated with increased pCR (70.6% vs. 60.7%, p = 0.049), while BRCA mutations showed a favorable trend. ECOG, BMI, pregnancy history, and comorbidities were not significantly associated with pCR. Conclusions: In this multicenter real-world cohort, maintaining chemotherapy dose intensity (RDI ≥ 85%) and completing all planned cycles were strongly associated with higher pCR rates, reinforcing the clinical importance of minimizing dose reductions and discontinuations during pembrolizumab-based neoadjuvant therapy for TNBC. Full article

(This article belongs to the Special Issue Advances in Neoadjuvant Chemotherapy and Radiotherapy for Breast Cancer: Surgical Impact and Clinical Outcomes)

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Advances in Neoadjuvant Chemotherapy and Radiotherapy for Breast Cancer: Surgical Impact and Clinical Outcomes

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