A MULTI-CENTRE study presented at ESMO Breast 2025 suggests that taxane-based chemotherapy significantly improves one-year survival in patients with metastatic triple-negative breast cancer (mTNBC) who exhibit high genomic instability, compared to platinum-based treatment.
Triple-negative breast cancer is one of the most aggressive and treatment-resistant forms of breast cancer, particularly in the metastatic stage. Researchers from Indonesia, led by Sakinah Rahma R. Sari, conducted a retrospective analysis of 45 mTNBC patients with high whole genomic instability (wGI) scores treated at multiple centres.
The analysis found that patients receiving taxane-based chemotherapy had notably better one-year overall survival. Adjusted multivariate modelling showed a hazard ratio (HR) of 0.23 (95% CI 0.07–0.75, p=0.02), indicating a 77% lower risk of death compared to other treatments. In contrast, those on platinum-based chemotherapy showed no significant survival benefit (HR=1.25, p=0.67).
The study also identified an immune-related marker, specifically the CD4/FOXP3 ratio, as significantly associated with improved survival (HR=0.28, p=0.01), suggesting a role for immune status in prognosis.
These findings highlight the potential of using genomic instability as a predictive marker for treatment response in mTNBC. The researchers advocate for the consideration of taxane-based regimens in patients with high genomic instability, while calling for further prospective studies to confirm these results and refine treatment selection in this high-risk population.
Reference
Sari SRR et al. Chemotherapy response in metastatic triple-negative breast cancer with genomic instability: A multi-center survival analysis. Abstract 377P. ESMO Breast; 14-17 May 2025.
