Cardiac safety of pembrolizumab-based neoadjuvant chemoimmunotherapy in early triple-negative breast cancer: real-world experience from a single centre

Clicks: 1
ID: 323454
2026
Free PDF
Article Quality & Performance Metrics
Overall Quality
Not rated
Combines reader engagement with the AI quality analysis. This article has not been analysed, so there is no overall score — reader engagement is measured and shown alongside.
AI Quality Assessment
Not analyzed
Readership in this journal

Ranked #122 of 282 articles by views in European heart journal supplements : journal of the European Society of Cardiology

Most read Least read

Bar heights use a square-root scale. Only the 120 most-read articles are drawn; the journal has 282 in total.

Mint this article as an NFT
Not yet minted

Create a permanent, verifiable on-chain record of this article on the Scimatic Network. The NFT is held in your Journament account, and you can withdraw it to your own wallet at any time.

5 SUSD one-off · no wallet required
Sign in to mint
Abstract
Abstract Introduction The KEYNOTE-522 study established a new standard of care for patients with high-risk early triple-negative breast cancer by introducing pembrolizumab in combination with neoadjuvant chemotherapy. Myocarditis is a known, although rare, immune-related adverse event associated with anti–PD-1 therapy, with a reported incidence of approximately 0.3–0.4% in clinical trials. Aim To evaluate cardiac events and treatment safety in patients treated at our University Hospital Centre. Materials and Methods A retrospective analysis was conducted including 45 patients with early triple-negative breast cancer who underwent surgery after completion of neoadjuvant therapy at our University Hospital Centre, between February 2024 and July 2025. Descriptive statistics were used to present demographic and clinical characteristics. Results The median age at diagnosis was 52 years (range 30–76). All patients were treated according to the trial protocol with pembrolizumab administered every 3 weeks in combination with chemotherapy (paclitaxel/carboplatin followed by anthracycline/cyclophosphamide), surgery, and one year of adjuvant pembrolizumab. The median number of administered anthracycline cycles was 4 (range 0–4), while the median number of pembrolizumab cycles was 17 (range 3–17). In all patients who completed the planned treatment, transthoracic echocardiography was performed either before treatment initiation or during neoadjuvant therapy prior to anthracycline administration. The median left ventricular ejection fraction (LVEF) was 64% (range 50–70%). Baseline NT-proBNP values were obtained in 76.3% of patients, while troponin I levels were measured in 64.8%.In two patients, NT-proBNP values were <8.3 ng/L; in the remaining patients, values ranged from 20 to 242 ng/L, with a median of 58.5 ng/L. Troponin I levels were <3.7 ng/L in 95.8% of patients, while one patient had a value of 11 ng/L. A total of four patients (6.6%) developed cardiac events, including atrial fibrillation with rapid ventricular response, immune-mediated myositis with severe hypothyroidism and mild pericardial effusion without LVEF impairment, and pulmonary embolism. Neoadjuvant therapy was discontinued in all cases, and patients proceeded to surgery. One additional patient developed suspected immune checkpoint inhibitor–related myocarditis after completion of neoadjuvant therapy and did not continue immunotherapy in the adjuvant setting. The median time to onset of cardiac symptoms was 4.5 months (range 2–8). Conclusion Our findings are consistent with limited real-world data, showing a 10–12% incidence of cardiovascular symptoms during chemo-immunotherapy and myocarditis rates comparable to clinical trials (~0.3–1.1%). The retrospective design limits the ability to attribute cardiac events solely to immunotherapy, underscoring the importance of baseline cardiovascular risk assessment and early detection of cardiotoxicity.
Reference Key
openalex_W7172311168 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors P Sertic, M Trajbar, L Ledinsky, T Gaberc, L Linaric, L J Vazdar, I D Gabric
Journal European heart journal supplements : journal of the European Society of Cardiology
Year 2026
DOI
10.1093/eurheartjsupp/suag097.174
URL
https://doi.org/10.1093/eurheartjsupp/suag097.174
Keywords Keywords not found

Citations

No citations found. To add a citation, contact the admin at info@scimatic.org

Comments

No comments yet. Be the first to comment on this article.