Evidence map›Paper›PMID 36449695›Full record

Trial reportClinical cancer research : an official journal of the American Association for Cancer Research2023

Survival Outcomes, Digital TILs, and On-treatment PET/CT During Neoadjuvant Therapy for HER2-positive Breast Cancer: Results from the Randomized PREDIX HER2 Trial.

Alexios Matikas, Hemming Johansson, Per Grybäck, Judith Bjöhle, Balazs Acs, Ceren Boyaci, Tobias Lekberg, Hanna Fredholm, Ellinor Elinder, Sara Margolin and 12 more

Abstract readClinical Trial, Phase IIRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Clinical cancer research : an official journal of the American Association for Cancer Research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers.

0numbers the graph read from it
0cells of the map it votes in
26citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

26 citing papers in PubMed.

  1. Trial
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  3. Restoring the CD226 in CD8Cell death & disease · 2026
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  5. Review
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  8. Article
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  10. Prognostic and recurrence risk predictive values of tumor infiltrating lymphocytes in HER2-low breast cancer.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2025
    Article
  11. Article
  12. Article
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  14. A compositeBreast (Edinburgh, Scotland) · 2025
    Article
  15. Article
  16. Article
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  19. Antibody drug conjugate, a level-up version of monoclonal antibody?International journal of surgery (London, England) · 2024
    Article
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

22 authors.

Alexios MatikasBreast Center, Theme Cancer, Karolinska University Hospital and Karolinska Comprehensive Cancer Center, Stockholm, Sweden.ORCID 0000-0002-4122-9624
Hemming JohanssonDepartment of Oncology/Pathology, Karolinska Institutet, Stockholm, Sweden.ORCID 0000-0002-7156-1468
Per GrybäckDepartment of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.ORCID 0000-0002-1141-6234
Judith BjöhleBreast Center, Theme Cancer, Karolinska University Hospital and Karolinska Comprehensive Cancer Center, Stockholm, Sweden.ORCID 0000-0002-1902-4032
Balazs AcsDepartment of Oncology/Pathology, Karolinska Institutet, Stockholm, Sweden.ORCID 0000-0002-0972-4633
Ceren BoyaciDepartment of Oncology/Pathology, Karolinska Institutet, Stockholm, Sweden.ORCID 0000-0001-5598-0243
Tobias LekbergBreast Center, Theme Cancer, Karolinska University Hospital and Karolinska Comprehensive Cancer Center, Stockholm, Sweden.ORCID 0000-0002-0467-9386
Hanna FredholmBreast Center, Theme Cancer, Karolinska University Hospital and Karolinska Comprehensive Cancer Center, Stockholm, Sweden.ORCID 0000-0002-2136-6162
Ellinor ElinderDepartment of Oncology, Södersjukhuset, Stockholm, Sweden.ORCID 0000-0001-8596-5327
Sara MargolinDepartment of Oncology, Södersjukhuset, Stockholm, Sweden.ORCID 0000-0002-5526-5570
Erika Isaksson-FrimanBreast Center, St Göran Hospital, Stockholm, Sweden.ORCID 0000-0001-8055-4297
Ana BoschDepartment of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, Sweden.ORCID 0000-0003-0666-5946
Henrik LindmanDepartment of Oncology, Uppsala University Hospital, Uppsala, Sweden.ORCID 0000-0002-5871-268X
Jamila AdraDepartment of Oncology, Sahlgrenska University Hospital, Göteborg, Sweden.ORCID 0000-0001-6361-661X
Anne AnderssonDepartment of Radiation Sciences, Oncology Unit, Umeå University Hospital, Umeå, Sweden.ORCID 0000-0002-9597-6465
Susanne AgartzDepartment of Oncology/Pathology, Karolinska Institutet, Stockholm, Sweden.ORCID 0000-0002-1895-2515
Mats HellströmBreast Center, Theme Cancer, Karolinska University Hospital and Karolinska Comprehensive Cancer Center, Stockholm, Sweden.ORCID 0000-0001-7897-4006
Ioannis ZerdesBreast Center, Theme Cancer, Karolinska University Hospital and Karolinska Comprehensive Cancer Center, Stockholm, Sweden.ORCID 0000-0002-8304-2462
Johan HartmanDepartment of Oncology/Pathology, Karolinska Institutet, Stockholm, Sweden.ORCID 0000-0002-6500-8527
Jonas BerghBreast Center, Theme Cancer, Karolinska University Hospital and Karolinska Comprehensive Cancer Center, Stockholm, Sweden.ORCID 0000-0001-5526-1847
Thomas HatschekBreast Center, Theme Cancer, Karolinska University Hospital and Karolinska Comprehensive Cancer Center, Stockholm, Sweden.ORCID 0000-0003-3067-2492
Theodoros FoukakisBreast Center, Theme Cancer, Karolinska University Hospital and Karolinska Comprehensive Cancer Center, Stockholm, Sweden.ORCID 0000-0001-8952-9987

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposePREDIX HER2 is a randomized Phase II trial that compared neoadjuvant docetaxel, trastuzumab, and pertuzumab (THP) with trastuzumab emtansine (T-DM1) for HER2-positive breast cancer. Rates of pathologic complete response (pCR) did not differ between the two groups. Here, we present the survival outcomes from PREDIX HER2 and investigate metabolic response and tumor-infiltrating lymphocytes (TIL) as prognostic factors. PATIENTS AND

methodsIn total, 202 patients with HER2-positive breast cancer were enrolled and 197 patients received six cycles of either THP or T-DM1. Secondary endpoints included event-free survival (EFS), recurrence-free survival (RFS), and overall survival (OS). Assessment with PET/CT was performed at baseline, after two and six treatment cycles. TILs were assessed manually at baseline biopsies, while image-based evaluation of TILs [digital TILs (DTIL)] was performed in digitized full-face sections.

resultsAfter a median follow-up of 5.21 years, there was no difference between the two treatment groups in terms of EFS [HR = 1.26; 95% confidence interval (CI), 0.54-2.91], RFS (HR = 0.69; 95% CI, 0.24-1.93), or OS (HR = 0.52; 95% CI, 0.09-2.82). Higher SUVmax at cycle 2 (C2) predicted lower pCR (ORadj = 0.65; 95% CI, 0.48-0.87; P = 0.005) and worse EFS (HRadj = 1.27; 95% CI, 1.12-1.41; P < 0.001). Baseline TILs and DTILs provided additional prognostic information to clinical parameters and C2 SUVmax.

conclusionsLong-term outcomes following neoadjuvant T-DM1 were similar to neoadjuvant THP. SUVmax after two cycles of neoadjuvant therapy for HER2-positive breast cancer may be an independent predictor of both short- and long-term outcomes. Combined assessment with TILs may facilitate early selection of poor responders for alternative treatment strategies.

Indexed as

Breast NeoplasmsAdo-Trastuzumab EmtansineAntineoplastic Combined Chemotherapy ProtocolsErb-b2 Receptor Tyrosine KinasesFemaleHumansLymphocytes, Tumor-InfiltratingNeoadjuvant TherapyPositron Emission Tomography Computed TomographyTrastuzumabAdo-Trastuzumab EmtansineErb-b2 Receptor Tyrosine KinasesTrastuzumab

Identifiers

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.