Araştırma Makalesi
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Hormon reseptörü pozitif, HER2 negatif metastatik meme kanseri tanısıyla ribosiklib veya palbosiklib ile letrozol kombinasyon tedavisi verilen hastalarda HER2-düşük ekspresyonunun önemi

Yıl 2025, Cilt: 16 Sayı: 2, 255 - 262, 30.06.2025
https://doi.org/10.18663/tjcl.1639022

Öz

Amaç: Metastatik meme kanserinin (MMK) en yaygın alt grubunu temsil eden hormon reseptörü (HR) pozitif, insan epidermal büyüme faktörü 2 (HER2) negatif meme kanseridir. Yakın dönemde HER2 negatif tümörler için daha ileri bir alt sınıflandırma olarak HER2-düşük terimi ortaya çıkmıştır. HER2-düşük ekspresyonunun, CDK 4/6 inhibitörleri ve hormonal tedavi kombinasyonuyla tedavi edilen HR-pozitif/HER2-negatif MMK'li hastaların sonuçları üzerindeki etkisine ilişkin sınırlı bilgi bulunmaktadır. Bu nedenle çalışmamızda bu hasta grubu için HER2-düşük durumuna göre sağkalım parametrelerini değerlendirdik.
Gereç ve Yöntemler: Türk Onkoloji Grubu (TOG) Projesi olarak Türkiye genelindeki 43 farklı tıbbi onkoloji merkezinden retrospektif olarak veri toplandı. Haziran 2016 ile Ağustos 2022 arasındaki dönemde Ribosiklib veya Palbosiklib ile letrozol kombinasyon tedavisi verilmiş HR-pozitif/HER2-negatif MMK'li 423 hastadan retrospektif olarak toplanan veriler değerlendirildi. Dahil edilen hastalar metastatik birinci basamak olarak tedaviye başlanan ve endokrin duyarlı hastalığa sahipti. Hastaların sağkalım sonuçları, HER2-negatif ve HER2- düşük hasta grubu arasında kıyaslandı.
Sonuç: HER2-düşük durumu, palbosiklib veya ribosiklib ile letrozol tedavisi alan hastalarda sağkalım üzerinde istatistiksel olarak anlamlı bir etki göstermedi.

Kaynakça

  • Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer statistics, 2022. CA Cancer J Clin 2022; 72: 7-33.
  • Cristofanilli M, Turner NC, Bondarenko I, Ro J, Im SA, Masuda N et al. Fulvestrant plus palbociclib versus fulvestrant plus placebo for treatment of hormone-receptor-positive, HER2-negative metastatic breast cancer that progressed on previous endocrine therapy (PALOMA-3): final analysis of the multicentre, double-blind, phase 3 randomised controlled trial. Lancet Oncol 2016; 17: 425-39.
  • Finn RS, Martin M, Rugo HS, Jones S, Im SA, Gelmon K et al. Palbociclib and Letrozole in Advanced Breast Cancer. N Engl J Med 2016; 375: 1925-36.
  • Hortobagyi GN, Stemmer SM, Burris HA, Yap YS, Sonke GS, Paluch-Shimon S et al. Ribociclib as First-Line Therapy for HR-Positive, Advanced Breast Cancer. N Engl J Med 2016; 375: 1738-48.
  • Tripathy D, Im SA, Colleoni M, Franke F, Bardia A, Harbeck N et al. Ribociclib plus endocrine therapy for premenopausal women with hormone-receptor-positive, advanced breast cancer (MONALEESA-7): a randomised phase 3 trial. Lancet Oncol 2018; 19: 904-15.
  • Slamon DJ, Neven P, Chia S, Fasching PA, De Laurentiis M, Im SA et al. Phase III Randomized Study of Ribociclib and Fulvestrant in Hormone Receptor-Positive, Human Epidermal Growth Factor Receptor 2-Negative Advanced Breast Cancer: MONALEESA-3. J Clin Oncol 2018; 36: 2465-72.
  • Goetz MP, Toi M, Campone M, Sohn J, Paluch-Shimon S, Huober J et al. MONARCH 3: Abemaciclib As Initial Therapy for Advanced Breast Cancer. J Clin Oncol 2017; 35: 3638-46.
  • Sledge GW Jr, Toi M, Neven P, Sohn J, Inoue K, Pivot X et al. The Effect of Abemaciclib Plus Fulvestrant on Overall Survival in Hormone Receptor-Positive, ERBB2-Negative Breast Cancer That Progressed on Endocrine Therapy-MONARCH 2: A Randomized Clinical Trial. JAMA Oncol 2020; 6: 116-24.
  • Tarantino P, Hamilton E, Tolaney SM, Cortes J, Morganti S, Ferraro E et al. HER2-Low Breast Cancer: Pathological and Clinical Landscape. J Clin Oncol 2020; 38: 1951-62.
  • Schettini F, Chic N, Braso-Maristany F, Pare L, Pascual T, Conte B et al. Clinical, pathological, and PAM50 gene expression features of HER2-low breast cancer. NPJ Breast Cancer 2021; 7: 1.
  • Horisawa N, Adachi Y, Takatsuka D, Nozawa K, Endo Y, Ozaki Y et al. The frequency of low HER2 expression in breast cancer and a comparison of prognosis between patients with HER2-low and HER2-negative breast cancer by HR status. Breast Cancer 2022; 29: 234-41.
  • Modi S, Park H, Murthy RK, Iwata H, Tamura K, Tsurutani J et al. Antitumor Activity and Safety of Trastuzumab Deruxtecan in Patients With HER2-Low-Expressing Advanced Breast Cancer: Results From a Phase Ib Study. J Clin Oncol 2020; 38: 1887-96.
  • Modi S, Jacot W, Yamashita T, Sohn J, Vidal M, Tokunaga E et al. Trastuzumab Deruxtecan in Previously Treated HER2-Low Advanced Breast Cancer. N Engl J Med 2022; 387: 9-20.
  • Frenel JS, Lusque A, Mailliez A, Bachelot T, Uwer L, Mouret Reyn‏ier MA et al. 291P HER2-low metastatic breast cancer (MBC): Management and prognosis of a new breast cancer entity in a real-world setting. Ann Oncol 2021; 32: S491.
  • Hein A, Hartkopf AD, Emons J, Lux MP, Volz B, Taran F-A et al. Prognostic effect of low-level HER2 expression in patients with clinically negative HER2 status. Eur J Cancer 2021; 155: 1-12.
  • Gampenrieder SP, Rinnerthaler G, Tinchon C, Petzer A, Balic M, Heibl S et al. Landscape of HER2-low metastatic breast cancer (MBC): results from the Austrian AGMT_MBC-Registry. Breast Cancer Res 2021; 23: 112.
  • Denkert C, Seither F, Schneeweiss A, Link T, Blohmer JU, Just M et al. Clinical and molecular characteristics of HER2-low-positive breast cancer: pooled analysis of individual patient data from four prospective, neoadjuvant clinical trials. Lancet Oncol 2021; 22: 1151-61.
  • Ergun Y, Ucar G, Akagunduz B. Comparison of HER2-zero and HER2-low in terms of clinicopathological factors and survival in early-stage breast cancer: A systematic review and meta-analysis. Cancer Treat Rev 2023; 115: 102538.
  • Hortobagyi GN, Stemmer SM, Burris HA, Yap YS, Sonke GS, Hart L et al. Overall Survival with Ribociclib plus Letrozole in Advanced Breast Cancer. N Engl J Med 2022; 386: 942-50.
  • Finn RS, Rugo HS, Dieras VC, Harbeck N, Im S-A, Gelmon KA et al. Overall survival (OS) with first-line palbociclib plus letrozole (PAL+LET) versus placebo plus letrozole (PBO+LET) in women with estrogen receptor–positive/human epidermal growth factor receptor 2–negative advanced breast cancer (ER+/HER2− ABC): Analyses from PALOMA-2. J Clin Oncol 2022; 40: LBA1003-LBA.
  • Goetz MP, Toi M, Huober J, Sohn J, Tredan O. MONARCH 3: Interim overall survival results of abemaciclib plus a nonsteroidal aromatase inhibitor in patients with HR+, HER2– advanced breast cancer. ESMO Congress 2022 Abstract LBA15.
  • Kahraman S, Erul E, Seyyar M, Gumusay O, Bayram E, Demirel BC et al. Treatment efficacy of ribociclib or palbociclib plus letrozole in hormone receptor-positive/HER2-negative metastatic breast cancer. Future Oncol 2023; 19: 727-36.
  • Bao KKH, Sutanto L, Tse SSW, Man Cheung K, Chan JCH. The Association of ERBB2-Low Expression With the Efficacy of Cyclin-Dependent Kinase 4/6 Inhibitor in Hormone Receptor-Positive, ERBB2-Negative Metastatic Breast Cancer. JAMA Netw Open 2021; 4: e2133132.
  • Douganiotis G, Kesisis G, Lalla E, Korantzis I, Boukovinas I, Papazisis K. Prognostic Significance of Low HER2 Expression in Patients With Metastatic Hormone Receptor-positive Breast Cancer Treated With First Line CDK4/6 Inhibitors: A Greek Multicenter Real-world Data Analysis. Cancer Diagn Progn 2022; 2: 585-91.
  • Shao Y, Luo Z, Yu Y, Chen Q, He Y, Liu C et al. HER2-low expression does not affect the clinical outcomes of metastatic breast cancer treated with CDK4/6 inhibitor: A real-world study. Front Endocrinol 2022; 13: 1000704.
  • Lapuchesky LS, Bortz M, Waisberg F, Enrico D. CDK4/6 inhibitors outcomes in patients with advanced breast cancer based on HER2-low expression. ASCO Annual Meeting; June 3-7, 2022, Chicago, IL. doi:10.1200/JCO.2022.40.16_suppl.1056.
  • Mouabbi JA, Raghavendra AS, Bassett RL Jr, Hassan A, Tripathy D, Layman RM. Histology-based survival outcomes in hormone receptor-positive metastatic breast cancer treated with targeted therapies. NPJ Breast Cancer 2022; 8: 131.
  • Önder T, Ateş Ö, Öner I, Karaçin C. Relationship between HER2-low status and efficacy of CDK4/6 inhibitors in advanced breast cancer: a real-world study. Int J Clin Oncol 2024; 29: 972-84.
  • Guliyev M, Şen GA, Gültürk İ, Majidova N, Akdağ G, Ahadzade A et al. The effects of low HER2 expression on survival in patients with metastatic breast cancer treated with CDK 4/6 inhibitors: a multicenter retrospective study. Breast Cancer Res Treat 2024; 205: 633-40.
  • Schlam I, Tolaney SM, Tarantino P. How I treat HER2-low advanced breast cancer. Breast 2023; 67: 116-23.

HER2-low expression in patients with hormone receptor positive and HER2 negative advanced breast cancer treated with ribociclib or palbociclib in combination with endocrine therapy

Yıl 2025, Cilt: 16 Sayı: 2, 255 - 262, 30.06.2025
https://doi.org/10.18663/tjcl.1639022

Öz

Aim: Hormone receptor (HR)-positive, human epidermal growth factor 2 (HER2)-negative breast cancer which represents the most common subgroup of metastatic breast cancer (MBC). Recently, further subclassification for HER2-negative tumors has emerged as HER2-low. There is limited knowledge regarding the effect of HER2-low expression on outcomes of patients with HR-positive and HER2-negative MBC treated with CDK 4/6 inhibitors plus hormonal therapy. Therefore, we evaluated survival parameters according to HER2-low status for this patient group in this study.
Material and Methods: As the Turkish Oncology Group (TOG) Project, retrospectively collected data from 423 patients with HR-positive/HER2-negative MBC treated with ribociclib and palbociclib plus letrozole therapy was assessed. Included patients had metastatic first-line therapy and endocrine-sensitive disease. Survival outcomes were compared between HER2-negative and HER2-low patient groups.
Conclusion: HER2-low status had no statistically significant impact on survival in patients treated with palbociclib or ribociclib plus letrozole.

Etik Beyan

The study protocol was approved by Ankara City Hospital Ethics Committee as a multicenter retrospective observational study in 22 December 2021 (E2-21-1167).

Destekleyen Kurum

The authors received no financial support for the research and/or authorship of this article.

Kaynakça

  • Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer statistics, 2022. CA Cancer J Clin 2022; 72: 7-33.
  • Cristofanilli M, Turner NC, Bondarenko I, Ro J, Im SA, Masuda N et al. Fulvestrant plus palbociclib versus fulvestrant plus placebo for treatment of hormone-receptor-positive, HER2-negative metastatic breast cancer that progressed on previous endocrine therapy (PALOMA-3): final analysis of the multicentre, double-blind, phase 3 randomised controlled trial. Lancet Oncol 2016; 17: 425-39.
  • Finn RS, Martin M, Rugo HS, Jones S, Im SA, Gelmon K et al. Palbociclib and Letrozole in Advanced Breast Cancer. N Engl J Med 2016; 375: 1925-36.
  • Hortobagyi GN, Stemmer SM, Burris HA, Yap YS, Sonke GS, Paluch-Shimon S et al. Ribociclib as First-Line Therapy for HR-Positive, Advanced Breast Cancer. N Engl J Med 2016; 375: 1738-48.
  • Tripathy D, Im SA, Colleoni M, Franke F, Bardia A, Harbeck N et al. Ribociclib plus endocrine therapy for premenopausal women with hormone-receptor-positive, advanced breast cancer (MONALEESA-7): a randomised phase 3 trial. Lancet Oncol 2018; 19: 904-15.
  • Slamon DJ, Neven P, Chia S, Fasching PA, De Laurentiis M, Im SA et al. Phase III Randomized Study of Ribociclib and Fulvestrant in Hormone Receptor-Positive, Human Epidermal Growth Factor Receptor 2-Negative Advanced Breast Cancer: MONALEESA-3. J Clin Oncol 2018; 36: 2465-72.
  • Goetz MP, Toi M, Campone M, Sohn J, Paluch-Shimon S, Huober J et al. MONARCH 3: Abemaciclib As Initial Therapy for Advanced Breast Cancer. J Clin Oncol 2017; 35: 3638-46.
  • Sledge GW Jr, Toi M, Neven P, Sohn J, Inoue K, Pivot X et al. The Effect of Abemaciclib Plus Fulvestrant on Overall Survival in Hormone Receptor-Positive, ERBB2-Negative Breast Cancer That Progressed on Endocrine Therapy-MONARCH 2: A Randomized Clinical Trial. JAMA Oncol 2020; 6: 116-24.
  • Tarantino P, Hamilton E, Tolaney SM, Cortes J, Morganti S, Ferraro E et al. HER2-Low Breast Cancer: Pathological and Clinical Landscape. J Clin Oncol 2020; 38: 1951-62.
  • Schettini F, Chic N, Braso-Maristany F, Pare L, Pascual T, Conte B et al. Clinical, pathological, and PAM50 gene expression features of HER2-low breast cancer. NPJ Breast Cancer 2021; 7: 1.
  • Horisawa N, Adachi Y, Takatsuka D, Nozawa K, Endo Y, Ozaki Y et al. The frequency of low HER2 expression in breast cancer and a comparison of prognosis between patients with HER2-low and HER2-negative breast cancer by HR status. Breast Cancer 2022; 29: 234-41.
  • Modi S, Park H, Murthy RK, Iwata H, Tamura K, Tsurutani J et al. Antitumor Activity and Safety of Trastuzumab Deruxtecan in Patients With HER2-Low-Expressing Advanced Breast Cancer: Results From a Phase Ib Study. J Clin Oncol 2020; 38: 1887-96.
  • Modi S, Jacot W, Yamashita T, Sohn J, Vidal M, Tokunaga E et al. Trastuzumab Deruxtecan in Previously Treated HER2-Low Advanced Breast Cancer. N Engl J Med 2022; 387: 9-20.
  • Frenel JS, Lusque A, Mailliez A, Bachelot T, Uwer L, Mouret Reyn‏ier MA et al. 291P HER2-low metastatic breast cancer (MBC): Management and prognosis of a new breast cancer entity in a real-world setting. Ann Oncol 2021; 32: S491.
  • Hein A, Hartkopf AD, Emons J, Lux MP, Volz B, Taran F-A et al. Prognostic effect of low-level HER2 expression in patients with clinically negative HER2 status. Eur J Cancer 2021; 155: 1-12.
  • Gampenrieder SP, Rinnerthaler G, Tinchon C, Petzer A, Balic M, Heibl S et al. Landscape of HER2-low metastatic breast cancer (MBC): results from the Austrian AGMT_MBC-Registry. Breast Cancer Res 2021; 23: 112.
  • Denkert C, Seither F, Schneeweiss A, Link T, Blohmer JU, Just M et al. Clinical and molecular characteristics of HER2-low-positive breast cancer: pooled analysis of individual patient data from four prospective, neoadjuvant clinical trials. Lancet Oncol 2021; 22: 1151-61.
  • Ergun Y, Ucar G, Akagunduz B. Comparison of HER2-zero and HER2-low in terms of clinicopathological factors and survival in early-stage breast cancer: A systematic review and meta-analysis. Cancer Treat Rev 2023; 115: 102538.
  • Hortobagyi GN, Stemmer SM, Burris HA, Yap YS, Sonke GS, Hart L et al. Overall Survival with Ribociclib plus Letrozole in Advanced Breast Cancer. N Engl J Med 2022; 386: 942-50.
  • Finn RS, Rugo HS, Dieras VC, Harbeck N, Im S-A, Gelmon KA et al. Overall survival (OS) with first-line palbociclib plus letrozole (PAL+LET) versus placebo plus letrozole (PBO+LET) in women with estrogen receptor–positive/human epidermal growth factor receptor 2–negative advanced breast cancer (ER+/HER2− ABC): Analyses from PALOMA-2. J Clin Oncol 2022; 40: LBA1003-LBA.
  • Goetz MP, Toi M, Huober J, Sohn J, Tredan O. MONARCH 3: Interim overall survival results of abemaciclib plus a nonsteroidal aromatase inhibitor in patients with HR+, HER2– advanced breast cancer. ESMO Congress 2022 Abstract LBA15.
  • Kahraman S, Erul E, Seyyar M, Gumusay O, Bayram E, Demirel BC et al. Treatment efficacy of ribociclib or palbociclib plus letrozole in hormone receptor-positive/HER2-negative metastatic breast cancer. Future Oncol 2023; 19: 727-36.
  • Bao KKH, Sutanto L, Tse SSW, Man Cheung K, Chan JCH. The Association of ERBB2-Low Expression With the Efficacy of Cyclin-Dependent Kinase 4/6 Inhibitor in Hormone Receptor-Positive, ERBB2-Negative Metastatic Breast Cancer. JAMA Netw Open 2021; 4: e2133132.
  • Douganiotis G, Kesisis G, Lalla E, Korantzis I, Boukovinas I, Papazisis K. Prognostic Significance of Low HER2 Expression in Patients With Metastatic Hormone Receptor-positive Breast Cancer Treated With First Line CDK4/6 Inhibitors: A Greek Multicenter Real-world Data Analysis. Cancer Diagn Progn 2022; 2: 585-91.
  • Shao Y, Luo Z, Yu Y, Chen Q, He Y, Liu C et al. HER2-low expression does not affect the clinical outcomes of metastatic breast cancer treated with CDK4/6 inhibitor: A real-world study. Front Endocrinol 2022; 13: 1000704.
  • Lapuchesky LS, Bortz M, Waisberg F, Enrico D. CDK4/6 inhibitors outcomes in patients with advanced breast cancer based on HER2-low expression. ASCO Annual Meeting; June 3-7, 2022, Chicago, IL. doi:10.1200/JCO.2022.40.16_suppl.1056.
  • Mouabbi JA, Raghavendra AS, Bassett RL Jr, Hassan A, Tripathy D, Layman RM. Histology-based survival outcomes in hormone receptor-positive metastatic breast cancer treated with targeted therapies. NPJ Breast Cancer 2022; 8: 131.
  • Önder T, Ateş Ö, Öner I, Karaçin C. Relationship between HER2-low status and efficacy of CDK4/6 inhibitors in advanced breast cancer: a real-world study. Int J Clin Oncol 2024; 29: 972-84.
  • Guliyev M, Şen GA, Gültürk İ, Majidova N, Akdağ G, Ahadzade A et al. The effects of low HER2 expression on survival in patients with metastatic breast cancer treated with CDK 4/6 inhibitors: a multicenter retrospective study. Breast Cancer Res Treat 2024; 205: 633-40.
  • Schlam I, Tolaney SM, Tarantino P. How I treat HER2-low advanced breast cancer. Breast 2023; 67: 116-23.
Toplam 30 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Onkoloji
Bölüm Araştırma Makalesi
Yazarlar

Seda Kahraman 0000-0002-5328-6554

Mutlu Hızal 0000-0001-5147-4431

Özge Gümüşay 0000-0002-6236-9829

Gül Başaran 0000-0002-0775-6180

Mustafa Seyyar 0000-0002-4841-7994

Elif Sahin 0000-0002-1976-3951

Devrim Çabuk 0000-0002-7871-6311

Alper Yaşar 0000-0001-8814-8947

Vedat Bayoğlu 0000-0002-0481-1084

Ertuğrul Bayram 0000-0001-8713-7613

Semra Paydaş 0000-0003-4642-3693

Burcu Gülbağcı 0000-0002-5720-8254

İlhan Hacıbekiroğlu 0000-0002-0333-7405

Burçin Çakan Demirel 0000-0003-0734-0692

Arzu Yaren 0000-0003-1436-8650

Melike Özçelik 0000-0003-0406-715X

Funda Yılmaz 0000-0002-7409-5730

Mutlu Doğan 0000-0001-9359-3770

Nail Paksoy 0000-0003-4636-2595

Adnan Aydıner 0000-0002-1104-5840

Olcun Umit Unal 0000-0001-7698-3574

Murat Keser 0000-0003-3834-0863

Esra Aydın 0000-0003-0210-3153

Erkan Kayıkçıoğlu 0000-0002-7401-5446

Bülent Çetin 0000-0001-8628-0864

Serkan Menekşe 0000-0002-2134-2128

Engin Kut 0000-0002-5328-5607

Kerem Okutur 0000-0002-8079-7739

Naziyet Köse Baytemur 0000-0002-3587-2517

Umut Demirci 0000-0002-4833-6721

Cihan Erol 0000-0003-3155-8798

Fatih Selçuk Biricik 0000-0002-1273-1674

Deniz Işık 0000-0003-4398-5148

Özgecan Dülgar 0000-0002-0678-4024

Teoman Sakalar 0000-0003-2749-9414

Başak Oyan Uluç 0000-0002-6623-6273

Sena Ece Davarcı 0000-0003-1142-9411

Hacer Demir 0000-0003-1235-9363

Ömer Acar 0000-0003-4408-1976

Atike Pinar Erdoğan 0000-0003-4859-7574

Sibel Oyucu Orhan 0000-0001-8217-3471

Erdem Çubukçu 0000-0002-0070-0889

Dinçer Aydın 0000-0002-0662-512X

Yusuf Karakas 0000-0003-0205-4590

Hakan Yücel 0000-0003-4711-1405

Gülhan Özkanlı 0000-0003-3912-7191

Eda Eylemer Mocan 0000-0003-0429-8142

Denizcan Güven 0000-0002-6924-9467

Orhan Önder Eren 0000-0001-6397-8207

Burak Bilgin 0000-0003-1717-8246

Nurhan Önal Kalkan 0000-0002-2823-332X

Yakup İriağaç 0000-0001-7411-1705

Muhammed Muhiddin Er 0000-0002-0583-0295

Nilgün Yıldırım 0000-0001-8198-2605

Merve Keskinkılıç 0000-0002-3342-3144

Özlem Özdemir 0000-0003-2520-5953

Veli Sunar 0000-0003-4672-4621

Nazım Serdar Turhal 0000-0002-1013-5676

Berna Bozkurt Duman 0000-0003-0295-6295

Muhammed Bülent Akıncı 0000-0001-7575-9925

Musa Barış Aykan 0000-0001-7538-9119

Müge Karaoğlanoğlu 0000-0003-0839-8191

Özlem Doğan 0000-0003-1023-8410

Ali İnal 0000-0001-9510-9858

Mehmet Ali Şendur 0000-0001-7021-6139

Yayımlanma Tarihi 30 Haziran 2025
Gönderilme Tarihi 13 Şubat 2025
Kabul Tarihi 9 Nisan 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 16 Sayı: 2

Kaynak Göster

APA Kahraman, S., Hızal, M., Gümüşay, Ö., Başaran, G., vd. (2025). HER2-low expression in patients with hormone receptor positive and HER2 negative advanced breast cancer treated with ribociclib or palbociclib in combination with endocrine therapy. Turkish Journal of Clinics and Laboratory, 16(2), 255-262. https://doi.org/10.18663/tjcl.1639022
AMA Kahraman S, Hızal M, Gümüşay Ö, Başaran G, Seyyar M, Sahin E, Çabuk D, Yaşar A, Bayoğlu V, Bayram E, Paydaş S, Gülbağcı B, Hacıbekiroğlu İ, Çakan Demirel B, Yaren A, Özçelik M, Yılmaz F, Doğan M, Paksoy N, Aydıner A, Unal OU, Keser M, Aydın E, Kayıkçıoğlu E, Çetin B, Menekşe S, Kut E, Okutur K, Köse Baytemur N, Demirci U, Erol C, Biricik FS, Işık D, Dülgar Ö, Sakalar T, Oyan Uluç B, Davarcı SE, Demir H, Acar Ö, Erdoğan AP, Oyucu Orhan S, Çubukçu E, Aydın D, Karakas Y, Yücel H, Özkanlı G, Eylemer Mocan E, Güven D, Eren OÖ, Bilgin B, Önal Kalkan N, İriağaç Y, Er MM, Yıldırım N, Keskinkılıç M, Özdemir Ö, Sunar V, Turhal NS, Bozkurt Duman B, Akıncı MB, Aykan MB, Karaoğlanoğlu M, Doğan Ö, İnal A, Şendur MA. HER2-low expression in patients with hormone receptor positive and HER2 negative advanced breast cancer treated with ribociclib or palbociclib in combination with endocrine therapy. TJCL. Haziran 2025;16(2):255-262. doi:10.18663/tjcl.1639022
Chicago Kahraman, Seda, Mutlu Hızal, Özge Gümüşay, Gül Başaran, Mustafa Seyyar, Elif Sahin, Devrim Çabuk, Alper Yaşar, Vedat Bayoğlu, Ertuğrul Bayram, Semra Paydaş, Burcu Gülbağcı, İlhan Hacıbekiroğlu, Burçin Çakan Demirel, Arzu Yaren, Melike Özçelik, Funda Yılmaz, Mutlu Doğan, Nail Paksoy, Adnan Aydıner, Olcun Umit Unal, Murat Keser, Esra Aydın, Erkan Kayıkçıoğlu, Bülent Çetin, Serkan Menekşe, Engin Kut, Kerem Okutur, Naziyet Köse Baytemur, Umut Demirci, Cihan Erol, Fatih Selçuk Biricik, Deniz Işık, Özgecan Dülgar, Teoman Sakalar, Başak Oyan Uluç, Sena Ece Davarcı, Hacer Demir, Ömer Acar, Atike Pinar Erdoğan, Sibel Oyucu Orhan, Erdem Çubukçu, Dinçer Aydın, Yusuf Karakas, Hakan Yücel, Gülhan Özkanlı, Eda Eylemer Mocan, Denizcan Güven, Orhan Önder Eren, Burak Bilgin, Nurhan Önal Kalkan, Yakup İriağaç, Muhammed Muhiddin Er, Nilgün Yıldırım, Merve Keskinkılıç, Özlem Özdemir, Veli Sunar, Nazım Serdar Turhal, Berna Bozkurt Duman, Muhammed Bülent Akıncı, Musa Barış Aykan, Müge Karaoğlanoğlu, Özlem Doğan, Ali İnal, ve Mehmet Ali Şendur. “HER2-Low Expression in Patients With Hormone Receptor Positive and HER2 Negative Advanced Breast Cancer Treated With Ribociclib or Palbociclib in Combination With Endocrine Therapy”. Turkish Journal of Clinics and Laboratory 16, sy. 2 (Haziran 2025): 255-62. https://doi.org/10.18663/tjcl.1639022.
EndNote Kahraman S, Hızal M, Gümüşay Ö, Başaran G, Seyyar M, Sahin E, Çabuk D, Yaşar A, Bayoğlu V, Bayram E, Paydaş S, Gülbağcı B, Hacıbekiroğlu İ, Çakan Demirel B, Yaren A, Özçelik M, Yılmaz F, Doğan M, Paksoy N, Aydıner A, Unal OU, Keser M, Aydın E, Kayıkçıoğlu E, Çetin B, Menekşe S, Kut E, Okutur K, Köse Baytemur N, Demirci U, Erol C, Biricik FS, Işık D, Dülgar Ö, Sakalar T, Oyan Uluç B, Davarcı SE, Demir H, Acar Ö, Erdoğan AP, Oyucu Orhan S, Çubukçu E, Aydın D, Karakas Y, Yücel H, Özkanlı G, Eylemer Mocan E, Güven D, Eren OÖ, Bilgin B, Önal Kalkan N, İriağaç Y, Er MM, Yıldırım N, Keskinkılıç M, Özdemir Ö, Sunar V, Turhal NS, Bozkurt Duman B, Akıncı MB, Aykan MB, Karaoğlanoğlu M, Doğan Ö, İnal A, Şendur MA (01 Haziran 2025) HER2-low expression in patients with hormone receptor positive and HER2 negative advanced breast cancer treated with ribociclib or palbociclib in combination with endocrine therapy. Turkish Journal of Clinics and Laboratory 16 2 255–262.
IEEE S. Kahraman, “HER2-low expression in patients with hormone receptor positive and HER2 negative advanced breast cancer treated with ribociclib or palbociclib in combination with endocrine therapy”, TJCL, c. 16, sy. 2, ss. 255–262, 2025, doi: 10.18663/tjcl.1639022.
ISNAD Kahraman, Seda vd. “HER2-Low Expression in Patients With Hormone Receptor Positive and HER2 Negative Advanced Breast Cancer Treated With Ribociclib or Palbociclib in Combination With Endocrine Therapy”. Turkish Journal of Clinics and Laboratory 16/2 (Haziran 2025), 255-262. https://doi.org/10.18663/tjcl.1639022.
JAMA Kahraman S, Hızal M, Gümüşay Ö, Başaran G, Seyyar M, Sahin E, Çabuk D, Yaşar A, Bayoğlu V, Bayram E, Paydaş S, Gülbağcı B, Hacıbekiroğlu İ, Çakan Demirel B, Yaren A, Özçelik M, Yılmaz F, Doğan M, Paksoy N, Aydıner A, Unal OU, Keser M, Aydın E, Kayıkçıoğlu E, Çetin B, Menekşe S, Kut E, Okutur K, Köse Baytemur N, Demirci U, Erol C, Biricik FS, Işık D, Dülgar Ö, Sakalar T, Oyan Uluç B, Davarcı SE, Demir H, Acar Ö, Erdoğan AP, Oyucu Orhan S, Çubukçu E, Aydın D, Karakas Y, Yücel H, Özkanlı G, Eylemer Mocan E, Güven D, Eren OÖ, Bilgin B, Önal Kalkan N, İriağaç Y, Er MM, Yıldırım N, Keskinkılıç M, Özdemir Ö, Sunar V, Turhal NS, Bozkurt Duman B, Akıncı MB, Aykan MB, Karaoğlanoğlu M, Doğan Ö, İnal A, Şendur MA. HER2-low expression in patients with hormone receptor positive and HER2 negative advanced breast cancer treated with ribociclib or palbociclib in combination with endocrine therapy. TJCL. 2025;16:255–262.
MLA Kahraman, Seda vd. “HER2-Low Expression in Patients With Hormone Receptor Positive and HER2 Negative Advanced Breast Cancer Treated With Ribociclib or Palbociclib in Combination With Endocrine Therapy”. Turkish Journal of Clinics and Laboratory, c. 16, sy. 2, 2025, ss. 255-62, doi:10.18663/tjcl.1639022.
Vancouver Kahraman S, Hızal M, Gümüşay Ö, Başaran G, Seyyar M, Sahin E, Çabuk D, Yaşar A, Bayoğlu V, Bayram E, Paydaş S, Gülbağcı B, Hacıbekiroğlu İ, Çakan Demirel B, Yaren A, Özçelik M, Yılmaz F, Doğan M, Paksoy N, Aydıner A, Unal OU, Keser M, Aydın E, Kayıkçıoğlu E, Çetin B, Menekşe S, Kut E, Okutur K, Köse Baytemur N, Demirci U, Erol C, Biricik FS, Işık D, Dülgar Ö, Sakalar T, Oyan Uluç B, Davarcı SE, Demir H, Acar Ö, Erdoğan AP, Oyucu Orhan S, Çubukçu E, Aydın D, Karakas Y, Yücel H, Özkanlı G, Eylemer Mocan E, Güven D, Eren OÖ, Bilgin B, Önal Kalkan N, İriağaç Y, Er MM, Yıldırım N, Keskinkılıç M, Özdemir Ö, Sunar V, Turhal NS, Bozkurt Duman B, Akıncı MB, Aykan MB, Karaoğlanoğlu M, Doğan Ö, İnal A, Şendur MA. HER2-low expression in patients with hormone receptor positive and HER2 negative advanced breast cancer treated with ribociclib or palbociclib in combination with endocrine therapy. TJCL. 2025;16(2):255-62.


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