Evidence map›Paper›PMID 42012678›Full record

ArticleArchives of gynecology and obstetrics2026

The adverse prognostic impact of reduced chemotherapy dose intensity appears attenuated in early breast cancer patients with treatment-relevant neutropenia: a retrospective cohort study.

K Eissler, T Engler, D Dannehl, B Schönfisch, J Englisch, A D Hartkopf, S Y Brucker, E M Grischke, L L Volmer, Alexander Englisch

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Archives of gynecology and obstetrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

10 authors.

K EisslerDepartment of Women's Health, Tuebingen University, 72076, Tuebingen, Germany.
T EnglerDepartment of Women's Health, Tuebingen University, 72076, Tuebingen, Germany.
D DannehlDepartment of Women's Health, Tuebingen University, 72076, Tuebingen, Germany.
B SchönfischDepartment of Women's Health, Tuebingen University, 72076, Tuebingen, Germany.
J EnglischDepartment of Women's Health, Tuebingen University, 72076, Tuebingen, Germany.
A D HartkopfDepartment of Women's Health, Tuebingen University, 72076, Tuebingen, Germany.
S Y BruckerDepartment of Women's Health, Tuebingen University, 72076, Tuebingen, Germany.
E M GrischkeDepartment of Women's Health, Tuebingen University, 72076, Tuebingen, Germany.
L L VolmerDepartment of Women's Health, Tuebingen University, 72076, Tuebingen, Germany.
Alexander EnglischDepartment of Women's Health, Tuebingen University, 72076, Tuebingen, Germany. alexander.englisch@med.uni-tuebingen.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeMaintaining a relative dose intensity (RDI) ≥ 85% during chemotherapy is established as a critical threshold for optimal outcomes in early breast cancer. This study investigates whether the prognostic impact of reduced RDI differs based on the presence of chemotherapy-induced neutropenia requiring treatment modifications (rCIN).

methodsWe analyzed 730 patients with early breast cancer receiving anthracycline/cyclophosphamide and taxane-based chemotherapy at the University Hospital Tübingen between 2014 and 2021. rCIN was defined as any dose reduction > 15%, delay ≥ 5 days, or discontinuation attributed to neutropenia per Common Terminology Criteria for Adverse Events (CTCAE) v5.0. Patients were stratified into four groups based on RDI (≥ 85% vs. < 85%) and rCIN status. Differences in overall survival (OS) and disease-free survival (DFS) were assessed by Kaplan-Meier analysis, and predictors of DFS were evaluated by Cox regression.

resultsrCIN occurred in 21.8% of patients, with 59.7% of rCIN patients receiving RDI < 85% versus 16.1% of non-rCIN patients (p < 0.001). Despite lower RDI, rCIN patients maintained similar pathological complete response rates after neoadjuvant therapy. In Kaplan-Meier analysis, patients with RDI < 85% without rCIN had significantly worse DFS and OS than the reference group with RDI ≥ 85% without rCIN (DFS p = 0.003; OS p = 0.002), while patients with RDI < 85% with rCIN showed comparable survival to high-RDI groups (all pairwise p > 0.170). Direct comparison between the two reduced-RDI groups was not statistically significant for either DFS or OS (DFS p = 0.055; OS p = 0.159). Cox regression confirmed RDI < 85% as a negative prognostic factor (HR 2.53; 95% CI 1.38-4.65; p = 0.003). The rCIN × RDI < 85% interaction term was not statistically significant (HR 0.44; 95% CI 0.12-1.60; p = 0.212).

conclusionsIn this retrospective cohort, reduced RDI was associated with poorer outcomes, particularly in patients without rCIN. By contrast, patients with RDI < 85% and rCIN showed no significant differences in Kaplan-Meier survival, and similar pathological complete response rates were observed despite lower RDI in the neoadjuvant subgroup. These findings are hypothesis-generating and require confirmation in larger prospective studies.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsBreast NeoplasmsNeutropeniaAdultAgedAnthracyclinesBridged-Ring CompoundsCyclophosphamideDisease-Free SurvivalDose-Response Relationship, DrugFemaleHumansKaplan-Meier EstimateMiddle AgedPrognosisRetrospective StudiesAnthracyclinesBridged-Ring CompoundsCyclophosphamidetaxaneTaxoidsAnthracycline–taxane chemotherapyChemotherapy–induced neutropeniaDose modifi cationsEarly breast cancerRelative dose intensity

Identifiers

PMID42012678
PMCPMC13100005

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.