# Neo-Real: adjuvant treatment patterns and safety after TNBC chemoimmunotherapy

Source: https://onco.cc/key-papers/paper-andrade-neo-real-adjuvant-safety-2026/  
OnCo record `paper-andrade-neo-real-adjuvant-safety-2026` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

After chemoimmunotherapy, combinations of additional drugs were common when cancer remained at surgery. This study describes safety, not whether the combinations improve survival.

## Summary

Brazilian/Argentinian real-world TNBC cohort: 726 included, 692 underwent surgery and safety information was available for 359. Among residual-disease participants without germline BRCA1/2 mutations, most received pembrolizumab/capecitabine; among the small BRCA-mutated residual group, pembrolizumab/olaparib was common. No survival outcomes are reported.

## Fields

- Kind: Key paper
- Last checked: 2026-10-10
- Journal: Breast Cancer Research and Treatment
- Year: 2026
- DOI: 10.1007/s10549-026-07938-0
- Authors: Andrade MO, Bonadio RC, Ipiña A, et al.
- Findings: Pembrolizumab alone had 6.7% grade ≥3 adverse events and lower incidence than combination regimens (p=0.002).; Drug discontinuation: pembrolizumab 5.7%, pembrolizumab/capecitabine 11.2%, pembrolizumab/olaparib 7.7% (p=0.126).
- What it means: Observational prescribing/safety data do not establish efficacy, comparative benefit or safety after prior pneumonitis.
- Caveats: Observational prescribing/safety data do not establish efficacy, comparative benefit or safety after prior pneumonitis.; Small olaparib-treated subgroup and incomplete safety capture; not evidence for somatic-only adjuvant PARP benefit.

## Sources

- Primary publication: https://doi.org/10.1007/s10549-026-07938-0
- PubMed record: https://pubmed.ncbi.nlm.nih.gov/41848921/

## Connected records

- cancers: [Breast cancer (all types)](https://onco.cc/cancers/breast-cancer/), [Triple-negative breast cancer (TNBC)](https://onco.cc/cancers/tnbc/)
- targets: [PARP](https://onco.cc/targets/parp/)
- drugs: [Capecitabine](https://onco.cc/drugs/capecitabine/), [Olaparib](https://onco.cc/drugs/olaparib/), [Pembrolizumab](https://onco.cc/drugs/pembrolizumab/)

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