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Multigene Signature Can Help Tailor Chemo for Operable Triple-Negative Breast Cancer

Improved three-year disease-free and recurrence-free survival seen with intensive chemotherapy regimen

By Elana Gotkine HealthDay Reporter

WEDNESDAY, Oct. 30, 2024 (HealthDay News) — For patients with operative triple-negative breast cancer, a multigene signature can help tailor adjuvant chemotherapy, according to a study published online Oct. 23 in The BMJ.

Min He, from Fudan University Shanghai Cancer and Key Laboratory of Breast Cancer, and colleagues conducted a randomized phase 3 trial in seven cancer centers in China involving female patients aged 18 to 70 years with early triple-negative breast cancer after definitive surgery. After risk stratification using a multigene signature, patients at high risk were randomly allocated to receive an intensive treatment regimen composed of docetaxel, epirubicin, and cyclophosphamide followed by four cycles of gemcitabine and cisplatin, or standard treatment (arm A: 166 patients; arm B: 170 patients). Patients at low risk received the same standard treatment (arm C: 168 patients).

The researchers found three-year disease-free survival rates of 90.9 and 80.6 percent for patients in arms A and B, respectively, at a median follow-up of 45.1 months (hazard ratio, 0.51). The three-year recurrence-free survival rate was 92.6 and 83.2 percent in arms A and B, respectively (hazard ratio, 0.50). The three-year overall survival rate did not differ significantly for patients in arms A and B. Patients in arm C had significantly higher rates of disease-free survival, recurrence-free survival, and overall survival than those in arm B receiving the same chemotherapy regimen.

“Intensive regimens incorporating gemcitabine and cisplatin led to significantly improved disease-free survival compared with standard anthracycline/taxane-based therapy in a well-defined subgroup of patients with operable triple-negative breast cancer,” the authors write.

Several authors disclosed ties to the biopharmaceutical industry.


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