ORIGINAL RESEARCH article
Front. Oncol.
Sec. Breast Cancer
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1592440
Clinical characteristics, treatment and survival of thrombocytopenia induced by T-DM1 in early HER2-positive breast cancer
Provisionally accepted
- Henan Provincial Cancer Hospital, Zhengzhou, China
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Backgroundword: Trastuzumab emtansine (T-DM1) is widely used for treating both early and advanced HER2-positive breast cancer in China. Thrombocytopenia represents a major adverse event associated with T-DM1 during anti-tumor therapy. Therefore, further exploration is needed to predict and mitigate T-DM1-induced platelet count decrease.Methods: We conducted a retrospective study utilizing electronic medical records from a single breast cancer center in Henan province. Clinicopathological characteristics and consecutive laboratory examination data were collected for all patients. 63 patients treated with T-DM1 were categorized into two groups: Thrombocytopenia and Non-thrombocytopenia. Statistical analyses employed Chisquared/Fishers exact test, F-test/Kruskal Wallis test, logistic regression and Kaplan-Meier methods.Results: A total of 63 HER2-positive patients receiving adjuvant T-DM1 were enrolled. A comparison between groups showed that patients in the Thrombocytopenia group were more frequently postmenopausal, had lymph node metastasis and had undergone radiotherapy. Postmenopausal status was identified as a risk factor for T-DM1-induced thrombocytopenia. Grade ≥2 thrombocytopenia occurred in 30 patients (47.6%) and grade ≥3 thrombocytopenia occurred in 16 patients (25.4%). Patients treated with rhIL-11(recombinant human interleukin-11) or rhTPO(recombinant human thrombopoietin) required a longer time for platelet(PLT) recovery to ≥75×10 9 /L and ≥100×10 9 /L compared to those receiving TPO-RAs(thrombopoietin receptor agonists), although this difference was not statistically significant. The estimated 1-year invasive disease-free survival(IDFS) for all T-DM1-treated patients was 96.8%.The 1year IDFS rates for the Thrombocytopenia and Non-thrombocytopenia groups were 100.0% and 93.9, respectively, with no statistically significant difference observed.Our findings indicate that T-DM1-induced thrombocytopenia was manageable in this cohort of breast cancer patients. Postmenopausal status correlated with an increased risk of platelet count decrease. Different platelet-producing drugs demonstrated comparable effectiveness in managing thrombocytopenia.
Keywords: HER2-positive breast cancer, T-DM1, Thrombocytopenia, Safety, effectiveness, Survival
Received: 12 Mar 2025; Accepted: 16 Jun 2025.
Copyright: © 2025 Wang, Zhang, Chen, Zhang and Zhenzhen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Liu Zhenzhen, Henan Provincial Cancer Hospital, Zhengzhou, China
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