Evidence map›Paper›PMID 39305392›Full record

Trial reportBreast cancer research and treatment2025

Regional lymph node changes on breast MRI in patients with early-stage breast cancer receiving neoadjuvant chemo-immunotherapy.

Saya Jacob, Anika Christofferson, Samantha Fisch, Peter Norwood, Paolo Castillo, Hongmei Yu, Gillian Hirst, Hatem Soliman, Rita Nanda, Rita A Mukhtar and 7 more

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Breast cancer research and treatment, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing 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

4 citing papers in PubMed.

  1. Article
  2. [Pseudoprogression after start of immunotherapy].Radiologie (Heidelberg, Germany) · 2026
    Review
  3. Article
  4. Monitoring Pharmacological Treatment of Breast Cancer with MRI.Current issues in molecular biology · 2025
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Saya JacobUniversity of California San Francisco Comprehensive Cancer Center, 1825 4 Street, San Francisco, CA, 94158, USA.
Anika ChristoffersonUniversity of California San Diego, 9500 Gilman Dr, La Jolla, CA, 92093, USA.
Samantha FischUniversity of California San Francisco Comprehensive Cancer Center, 1825 4 Street, San Francisco, CA, 94158, USA.
Peter NorwoodQuantum Leap Healthcare Collaborative, 499 Illinois Ave, Suite 200, San Francisco, CA, 94158, USA.
Paolo CastilloUniversity of California San Francisco Comprehensive Cancer Center, 1825 4 Street, San Francisco, CA, 94158, USA.
Hongmei YuQuantum Leap Healthcare Collaborative, 499 Illinois Ave, Suite 200, San Francisco, CA, 94158, USA.
Gillian HirstUniversity of California San Francisco Comprehensive Cancer Center, 1825 4 Street, San Francisco, CA, 94158, USA.
Hatem SolimanMoffit Cancer Center, 10920 N. McKinley Drive, Tampa, FL, 33612, USA.
Rita NandaUniversity of Chicago, 5841 S. Maryland Avenue, Chicago, IL, 60637, USA.
Rita A MukhtarUniversity of California San Francisco Comprehensive Cancer Center, 1825 4 Street, San Francisco, CA, 94158, USA.
Cheryl EwingUniversity of California San Francisco Comprehensive Cancer Center, 1825 4 Street, San Francisco, CA, 94158, USA.
Melanie MajureUniversity of California San Francisco Comprehensive Cancer Center, 1825 4 Street, San Francisco, CA, 94158, USA.
Michelle MeliskoUniversity of California San Francisco Comprehensive Cancer Center, 1825 4 Street, San Francisco, CA, 94158, USA.
Hope S RugoUniversity of California San Francisco Comprehensive Cancer Center, 1825 4 Street, San Francisco, CA, 94158, USA.
Laura EssermanUniversity of California San Francisco Comprehensive Cancer Center, 1825 4 Street, San Francisco, CA, 94158, USA.
Elissa PriceUniversity of California San Francisco Comprehensive Cancer Center, 1825 4 Street, San Francisco, CA, 94158, USA.
A Jo ChienUniversity of California San Francisco Comprehensive Cancer Center, 1825 4 Street, San Francisco, CA, 94158, USA. jo.chien@ucsf.edu.

Funding

The I SPY 2.2 TRIAL: Evolving to Imaging and Molecular Biomarker Response Directed Adaptive Sequential Treatment to Optimize Breast Cancer OutcomesP01CA210961 · NCI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Nola M. Hylton-Watson · 2017 to 2026
$22.9M
NCI NIH HHS P01 CA210961
6 · The paper itself

Abstract

purposeEstablishing breast MRI imaging patterns associated with neoadjuvant immunotherapy is needed to monitor response. We analyzed serial breast MRIs in patients receiving neoadjuvant chemo-immunotherapy on the I-SPY2 clinical trial.

methodsPatients with stage 2-3 HER2-negative breast cancer were randomized to weekly paclitaxel (control), weekly paclitaxel and pembrolizumab, or weekly paclitaxel, pembrolizumab and intra-tumoral injection of SD-101, a TLR9 agonist. All patients received AC. Regional lymph nodes were retrospectively evaluated on breast MRI at baseline, 3, 12 and 20 weeks by a single blinded radiologist. MRIs were assessed for development of new regional lymphadenopathy, or increase in the longest diameter or cortical thickness of the largest abnormal regional lymph node.

resultsBetween 12/2015 and 4/2021, a total of 43 patients enrolled in the control (n = 16) and paclitaxel + pembrolizumab ± SD-101 (n = 27) arms. 12 of 27 patients (44.4%) receiving chemo-immunotherapy experienced increased lymphadenopathy within the first 12 weeks compared to 1 of 16 patients (6.3%) in the control group (p = 0.014). Most patients with increased lymphadenopathy were in the SD101/pembro arm (n = 10, p = 0.002). Increased lymphadenopathy was observed despite concomitant decrease in breast tumor size at all time points. 11 of 12 patients with increased lymphadenopathy had pathologically negative nodes at surgery. There was no association between lymphadenopathy and lower residual cancer burden or immune-related toxicity.

conclusionsThe combination of neoadjuvant paclitaxel and pembrolizumab ± SD101 intratumoral injection was associated with early increases in regional lymphadenopathy on MRI despite decreased breast tumor size. Increased lymphadenopathy was not associated with node positive disease at surgery.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsBreast NeoplasmsLymph NodesMagnetic Resonance ImagingAdultAgedAntibodies, Monoclonal, HumanizedFemaleHumansLymphatic MetastasisMiddle AgedNeoadjuvant TherapyNeoplasm StagingPaclitaxelRetrospective StudiesAntibodies, Monoclonal, HumanizedPaclitaxelpembrolizumabBreast MRIEarly-stage breast cancerImmunotherapyneoadjuvant chemotherapy

Identifiers

PMID39305392
PMCPMC11785630

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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.