Chinese experts’ -prediction of prognosis + precise chemotherapy plan- brings greater hope to patients with the -most toxic breast cancer-
In an interview, Professor Shao Zhimin from the Fudan University Affiliated Tumor Hospital shed light on the challenges of treating triple-negative breast cancer (TNBC), which accounts for approximately 15-20% of all breast cancer cases. Widely regarded as the “most aggressive breast cancer,” TNBC has a high degree of malignancy, a tendency to metastasize, and limited targeted treatment options.
A team of Chinese experts has developed a “multi-gene model” specifically for predicting outcomes in TNBC patients, which allows for a more precise treatment protocol. This model combines sequential therapies of “anthracycline” and “taxanes” with “gemcitabine” and “carboplatin,” leading to an impressive increase of more than 10% in survival rates for high-risk patients. This advancement represents a significant shift from the conventional “one-size-fits-all” chemotherapy approach used in treating TNBC.
On October 24, the British Medical Journal published the team’s groundbreaking research, showcasing their collaboration among several institutions, including the Fudan University Affiliated Tumor Hospital’s breast surgery department, led by Professors Shao Zhimin, Wang Zhonghua, and Jiang Yizhou.
In recent years, research has confirmed that TNBC is highly heterogeneous and can be further classified. Clinicians have observed that while overall prognoses for TNBC patients are often poor, not all individuals experience recurrences or metastases. There is an urgent need for more specialized treatment strategies.
Currently, adjuvant chemotherapy for TNBC relies on traditional treatment methods due to a lack of clinically validated tools or models to predict recurrence risk accurately, hampering personalized treatment efforts.
In 2015, a team led by Professors Shao and Jiang developed a novel prognostic model composed of five RNA markers specifically for TNBC. This multi-gene model provides a theoretical foundation for personalized chemotherapy.
Professor Wang Zhonghua detailed that their department coordinated a clinical study involving six other centers across mainland China. Patients were categorized into high-risk and low-risk groups based on the multi-gene model. High-risk patients were then randomized to receive either intensified or standard chemotherapy. After a median follow-up of 45 months, the three-year disease-free survival rate for patients receiving intensified treatment was 90.9%, compared to 80.6% for those receiving standard treatment—a 49% reduction in disease risk. The three-year recurrence-free survival rate for the intensified group was 92.6%, surpassing the standard group at 83.2%, effectively halving the risk of recurrence for high-risk patients.
Professor Shao noted that the multi-gene model-guided treatment also led to nearly a 10% boost in survival rates for low-risk patients. Professor Wang emphasized that this research has internationally validated the efficacy of the multi-gene model in guiding precision chemotherapy and predicting patient outcomes.
Finally, Professor Jiang Yizhou, the hospital’s deputy director and head of the clinical research center, revealed that based on these findings, they are preparing to launch a step-down treatment protocol for low-risk TNBC patients predicted by the multi-gene model.
