Clinico-pathological factors predicting pathological response in early triple-negative breast cancer
Pathological complete response (pCR) after neoadjuvant chemoimmunotherapy (NACi) is associated with improved patient outcomes in early triple-negative breast cancer (TNBC). This study aimed to identify factors associated with pCR after NACi. This cohort included all patients with stage II-III TNBC treated with NACi who underwent surgery at Institut Curie hospitals between 08/2021-06/2023. Among 208 patients, the overall pCR rate was 70% and was similar in ER < 1% (69%) and ER-low TNBC (73%, p = 0.6). In a multivariate model, Ki-67 ≥ 30% (OR 5.19 [1.73-17.3]), centralized TILs ≥ 30% (OR = 3.08 [1.42-7.04]), absence of DCIS at initial biopsy (OR = 2.56 [1.08-6.25]) and germline mutations in homologous recombination genes (OR = 9.50 [2.37-67.7]) remained strong independent predictors of pCR. These findings may guide treatment decisions in patients with TNBC undergoing NACi. Almost all patients with germline mutations in HR genes achieved pCR, supporting de-escalation trials. We suggest that ER-low tumors should be managed as TNBC tumors.
Authors
- Toulsie Ramtohul (ORCID: https://orcid.org/0000-0002-8440-7785)
- François‐Clément Bidard (ORCID: https://orcid.org/0000-0001-5932-8949)
- Emanuela Romano
- Matthieu Carton (ORCID: https://orcid.org/0000-0002-6793-3273)
- Paul Henri Cottu (ORCID: https://orcid.org/0000-0001-6434-3932)
- Enora Laas (ORCID: https://orcid.org/0000-0003-3875-4011)
- Anne Vincent‐Salomon (ORCID: https://orcid.org/0000-0001-5754-5771)
- Ivan Bièche (ORCID: https://orcid.org/0000-0002-2430-5429)
- Clara Helal (ORCID: https://orcid.org/0000-0002-7318-9962)
- Claire Bonneau (ORCID: https://orcid.org/0000-0001-6251-286X)
- Romain‐David Seban (ORCID: https://orcid.org/0000-0002-2584-5478)
- Luc Cabel (ORCID: https://orcid.org/0000-0001-5515-9180)
- Nicolas Kiavué (ORCID: https://orcid.org/0000-0002-5713-833X)
- Diana Bello-Roufai
- Lounes Djerroudi (ORCID: https://orcid.org/0000-0002-5007-2964)
- Delphine Loirat
- Maxime Jin
- Florence Lerebours
Institutions
- Université de Versailles Saint-Quentin-en-Yvelines (FR)
- Université Paris Cité (FR)
- Université Paris Sciences et Lettres (FR)
- Université Paris-Saclay (FR)
- St. Cloud Hospital (US)
- Institut Curie (FR)
Publication Details
- Journal
- npj Breast Cancer
- Published
- 2025-02-13
- DOI
- https://doi.org/10.1038/s41523-025-00729-8
- Citations
- 20
- Primary Topic
- Breast Cancer Treatment Studies
- Type
- article
- Field-Weighted Citation Impact
- 18.72
Funders
- Agence Nationale de la Recherche