Translational breast cancer research : a journal focusing on translational research in breast cancer最新文献

{"title":"Axillary surgery in the cyclin-dependent kinase 4/6 inhibitors era: no time to move backward.","authors":"María Jesús Pla-Farnós, Eduard Mension, María Isabel Gallegos, José Ignacio Sánchez-Méndez","doi":"10.21037/tbcr-2025-1-76","DOIUrl":"10.21037/tbcr-2025-1-76","url":null,"abstract":"<p><p>Axillary lymph node involvement remains one of the strongest prognostic factors in early breast cancer and continues to guide both surgical and adjuvant treatment decisions. Historically, axillary lymph node dissection (ALND) represented the standard staging approach, but it is associated with substantial morbidity, including a significant risk of lymphedema. Over recent decades, robust evidence from multiple surgical de-escalation trials has demonstrated that less invasive approaches-most notably sentinel lymph node biopsy (SLNB) and omission of ALND in selected scenarios-have significantly reduced axillary morbidity without compromising oncologic outcomes. As a result, international guidelines support omission of ALND in clinically node-negative (cN0) tumors with limited nodal involvement. The monarchE trial introduced a new clinical dilemma. Abemaciclib, a cyclin-dependent kinase 4/6 (CDK4/6) inhibitor, combined with endocrine therapy, showed a clinically meaningful improvement in invasive disease-free survival (IDFS) among patients with luminal human epidermal growth factor receptor 2 (HER2)-negative, high‑risk early breast cancer. Eligibility criteria required either ≥4 positive lymph nodes or 1-3 nodes with additional high-risk features. Consequently, some clinicians have questioned whether ALND should be reconsidered to ensure accurate identification of patients who may benefit from adjuvant CDK4/6 inhibition. However, accumulating evidence challenges this rationale. Randomized trials such as ACOSOG-Z0011, AMAROS and SENOMAC have shown no survival advantage from completion ALND in patients with 1-2 positive sentinel nodes, while analyses from large databases indicate that only a minority harbor ≥4 positive nodes. Moreover, recent post‑hoc analyses suggest that more than one hundred ALNDs would be required to prevent a single recurrence at five years, exposing many patients to unnecessary morbidity. Thus, the risk-benefit balance of performing ALND solely to expand eligibility for abemaciclib appears unfavorable. Emerging data from the NATALEE trial further broaden the therapeutic landscape by showing that ribociclib provides IDFS benefits not only in node-positive disease but also in high-risk node-negative patients. This expanded indication reduces the clinical relevance of extensive nodal staging for determining eligibility for CDK4/6 inhibition. Overall, current evidence does not support performing ALND solely to increase the number of patients eligible for abemaciclib, and nodal burden alone should not drive more aggressive axillary interventions in early breast cancer.</p>","PeriodicalId":101427,"journal":{"name":"Translational breast cancer research : a journal focusing on translational research in breast cancer","volume":"7 ","pages":"33"},"PeriodicalIF":1.4,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13458067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148715074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of circulating tumor cell clusters in breast cancer.","authors":"Gerhard Hamilton, Marie-Therese Eggerstorfer, Sandra Stickler","doi":"10.21037/tbcr-2025-1-60","DOIUrl":"10.21037/tbcr-2025-1-60","url":null,"abstract":"<p><p>Breast cancer (BC) in the metastatic state has disseminated to lungs, bones and brain resulting in a poor prognosis and high mortality. Cancer cells separate from the primary lesion and intravasate as circulating tumor cells (CTCs) to generate distal metastases following extravasation and colonization of target tissues. CTCs are infrequently detectable at low numbers in nonmetastatic BC but occur at higher cell counts in metastatic BC, where they are an independent predictor of shorter disease-free survival and overall survival. CTCs exist as single cells or as homotypic or heterotypic clusters with reportedly higher metastatic potential as demonstrated by murine patient-derived xenograft (PDX)/cell line-derived xenograft (CDX) models and correlation with a poorer survival in patients. Homotypic clusters are made of cancer cells only, in contrast to heterotypic clusters that incorporate stromal or immune cells along with cancer cells. However, experimental animal models with highly active CTCs and rapid formation of metastases are a poor representation of clinical BC with one metastasis-inducing CTC among 60 million cancer cells and a time to metastasis of several years. CTC clusters are rapidly cleared from the circulation but within the time frame of the PDX/CDX models, these cell aggregates will not be able to grow, extravasate and generate additional metastases, nor will their disaggregation prevent metastasis. The generation of CTC clusters is most likely due to larger originating tumors that contain accordingly large and leaky tumor vessels that allow the release of several associated tumor cells instead of single CTCs. Tumor size and microvascular density are well-known prognostic parameters in BC.</p>","PeriodicalId":101427,"journal":{"name":"Translational breast cancer research : a journal focusing on translational research in breast cancer","volume":"7 ","pages":"32"},"PeriodicalIF":1.4,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13458074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors associated with cardiac events among breast cancer survivors at a Saudi tertiary cancer center: a retrospective cohort study.","authors":"Nora H Trabulsi, Rozan Altaifi, Bana Fakieh, Nada Alkhateeb, Feryal Attiah, Salma Sait, Alaa Shabkah, Sarah Almaghrabi, Marwan Al-Hajeili, Reem Ujaimi, Ali Farsi","doi":"10.21037/tbcr-2025-1-78","DOIUrl":"10.21037/tbcr-2025-1-78","url":null,"abstract":"<p><strong>Background: </strong>Cardiac disease and cancer are leading global causes of death. The prevalence of breast cancer (BC) is rising, and although advances in therapy have significantly improved BC survival, some treatments increase the risk of long-term cardiac events. In this retrospective study, we assessed the prevalence of cardiac events and risk factors in patients with BC.</p><p><strong>Methods: </strong>The study included all adult women diagnosed with BC from 2008 to 2020 at King Abdulaziz University Hospital. Patient data were collected in an Excel worksheet and analyzed with SPSS 25.0.</p><p><strong>Results: </strong>Our study included 676 patients with BC, with 57.34% were aged 41-60 years, and 38.1% were obese. Mastectomy was performed in 58.28% of cases. Cardiac events occurred in 6.07% of patients, with a higher incidence in those aged >80 years (P=0.04). Significant associations were found between cardiac events and diabetes, ischemic heart disease (IHD), heart failure, peripheral vascular disease, and dyslipidemia (P<0.001). Furthermore, a significant association was found between cardiac events and the mortality of patients with BC (P<0.001). Although no significant association was found between radiotherapy and cardiac events (P=0.64), they were significantly associated with adjuvant chemotherapy (P=0.01) and the anti-human epidermal growth factor receptor 2 (HER2) drug trastuzumab (P=0.03).</p><p><strong>Conclusions: </strong>Cardiac events in BC patient are associated with higher mortality and found more prevalent in patient receiving anti-HER2 treatments and chemotherapy. Larger randomized controlled trials are needed to further identify patients at high risk and guide prevention strategies.</p>","PeriodicalId":101427,"journal":{"name":"Translational breast cancer research : a journal focusing on translational research in breast cancer","volume":"7 ","pages":"25"},"PeriodicalIF":1.4,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13458069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148715175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimal-access nipple-sparing mastectomy: current evidence, limitations, and future evaluation.","authors":"Mariam Rizk, Kefah Mokbel","doi":"10.21037/tbcr-2025-1-84","DOIUrl":"10.21037/tbcr-2025-1-84","url":null,"abstract":"","PeriodicalId":101427,"journal":{"name":"Translational breast cancer research : a journal focusing on translational research in breast cancer","volume":"7 ","pages":"36"},"PeriodicalIF":1.4,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13458270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148715053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of acute myeloid leukemia (AML) in two breast cancer patients undergoing treatment with long-term palbociclib: a dual case report.","authors":"Mahmoud Abdelsalam, Maged Salem, Nizar Abdel Samad, Eric Manuel, Muhammad Rasul, James Dixon, Laura Ross, Ian C Chute, Mekayla Wallace","doi":"10.21037/tbcr-2025-1-72","DOIUrl":"10.21037/tbcr-2025-1-72","url":null,"abstract":"<p><strong>Background: </strong>Acute myeloid leukemia (AML) can develop after exposure to certain cytotoxic agents. Palbociclib, a cyclin-dependent kinases 4 and 6 (CDK4/6) inhibitor used to treat hormone receptor-positive, human epidermal growth factor receptor 2 (HER2)-negative advanced breast cancer, is known for hematologic side effects but rarely associated with secondary hematologic malignancies.</p><p><strong>Case description: </strong>We report two cases of AML development during prolonged breast cancer treatment with palbociclib, exploring a possible association. Case 1: a 63-year-old female diagnosed with stage I estrogen receptor (ER)/progesterone receptor (PR)-positive, HER2-negative breast cancer in 2010, treated with radiation and letrozole. Metastatic recurrence in 2019 prompted initiation of letrozole and palbociclib. In 2024, she developed anemia, neutrophilia, and circulating blasts, with bone marrow biopsy confirming AML. She was treated with azacitidine and venetoclax with poor response and died in 2025 from septic shock following surgery. Case 2: a 44-year-old female diagnosed with stage II hormone receptor-negative breast cancer in 1993, treated with surgery and chemotherapy. A local recurrence in 2005 was ER/PR-positive and she received letrozole until 2013. In 2017, she developed metastases and started letrozole and palbociclib. In 2025, she presented with pancytopenia and was diagnosed with AML. She received six cycles of azacitidine and venetoclax before progression and died later the same year.</p><p><strong>Conclusions: </strong>These cases explore a possible link between prolonged palbociclib therapy and AML development, warranting further investigation and monitoring.</p>","PeriodicalId":101427,"journal":{"name":"Translational breast cancer research : a journal focusing on translational research in breast cancer","volume":"7 ","pages":"35"},"PeriodicalIF":1.4,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13458269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148715126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ESR1 fusions in breast cancer: functions, mechanisms and therapeutic opportunities.","authors":"Xuxu Gou, Zoya Farooqui, Charles E Foulds","doi":"10.21037/tbcr-2025-1-63","DOIUrl":"10.21037/tbcr-2025-1-63","url":null,"abstract":"<p><p>Approximately 70% of all breast cancers are driven by estrogen receptor-alpha (ERα) that binds the predominant circulating female estrogen, 17ꞵ-estradiol (E2). Because of this, drugs collectively termed \"endocrine therapy (ET)\" that either suppress E2 level or inhibit the activity of ERα have been used as first-line therapy. While initially effective, resistance to ET drugs occurs with subsequent lethal metastasis. The most common genetic alterations are point mutations in the <i>ESR1</i> gene within the last exon encoding the ligand-binding domain (LBD), resulting in constitutively active ERα proteins. Recently, new oral selective estrogen receptor degraders (SERDs) that effectively target these point mutants have been Food and Drug Administration (FDA)-approved. In addition to these point mutations, <i>ESR1</i> can undergo chromosomal translocations that produce gene fusions. One type of these fusions allows the <i>ESR1</i> gene promoter to drive expression of the partner gene as a \"promoter switch\". The other type of <i>ESR1</i> translocation creates a chimeric ESR1 fusion protein that contains the N-terminus, DNA-binding domain (DBD), and hinge region of ERα, but has the LBD replaced by a partner protein. Many of these in-frame <i>ESR1</i> fusions have constitutive activity and cannot be inhibited by any ET, as the LBD of ERα is missing. This latter group of ESR1 fusion proteins promotes ET-resistance and invasive properties in cell lines and metastasis in mouse xenograft experiments. This review largely focuses on the in-frame chimeric <i>ESR1</i> fusion proteins, highlighting current knowledge gaps in their mechanism(s) of action and how tumors that express them might be therapeutically targeted.</p>","PeriodicalId":101427,"journal":{"name":"Translational breast cancer research : a journal focusing on translational research in breast cancer","volume":"7 ","pages":"29"},"PeriodicalIF":1.4,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13458063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148715090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Progress of Trop-2-targeted antibody-drug conjugates in HER-2-negative breast cancer: a mini-review.","authors":"Xu Liang, Guohong Song","doi":"10.21037/tbcr-2025-1-79","DOIUrl":"10.21037/tbcr-2025-1-79","url":null,"abstract":"<p><p>Breast cancer (BC) persists as a major cause of deaths associated with cancer among women globally, emphasizing the urgent need for innovative therapies. Trophoblast cell surface antigen 2 (Trop-2), a transmembrane glycoprotein involved in tumor growth, proliferation, and metastasis, has emerged as a promising therapeutic target. Trop-2-targeted antibody-drug conjugates (ADCs) improve the efficacy and reduce the safety concerns while compared to traditional chemotherapy by selectively delivering cytotoxic agents to tumor cells that express Trop-2. The expression of Trop-2 is higher in many solid tumors and is associated with poor prognosis. Various Trop-2-targeted ADCs, such as sacituzumab govitecan (SG), sacituzumab tirumotecan (SKB264), and datopotamab deruxtecan (Dato-DXd), are being actively investigated for advanced triple-negative breast cancer (TNBC) and hormone receptor-positive (HR+) and human epidermal growth factor receptor 2-negative (HER2-) BC. This review discusses the clinical progress and outcomes of these Trop-2 ADCs, their potential utility in combination with immunotherapy and poly (ADP-ribose) polymerase (PARP) inhibitors and the ongoing clinical trials, and their efficacy in the treatment of patients with brain metastases, shaping the future of Trop-2-directed cancer treatment. Overall, Trop-2-targeted ADCs were promising in treating HER2- BC, with the potential to improve patient outcomes, enhance the quality of life, and pave the way for future Trop-2-focused research. Especially, SG has shown substantial efficacy in treating both TNBC and HR+/HER2- BC, with a tolerable safety profile, and an encouraging efficacy over standard chemotherapy. Trop-2 ADCs have made significant progress in BC therapy; however, many challenges remain, which require further investigation.</p>","PeriodicalId":101427,"journal":{"name":"Translational breast cancer research : a journal focusing on translational research in breast cancer","volume":"7 ","pages":"27"},"PeriodicalIF":1.4,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13458267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148715139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chinese Society of Clinical Oncology breast cancer expert consensus on the diagnosis and treatment of breast cancer brain metastasis (2025).","authors":"Tao Wang, Jiayi Chen, Jin Yang, Minjie Fu, Wei Hua, Wang Jia, Yueping Liu, Biyun Wang, Min Yan, Chunfang Hao, Jiaxin Chen, Dan Ou, Erwei Song, Tao Jiang, Ying Mao, Zefei Jiang","doi":"10.21037/tbcr-25-51","DOIUrl":"10.21037/tbcr-25-51","url":null,"abstract":"<p><strong>Background: </strong>Globally, breast cancer (BC) ranks among the most frequently diagnosed malignant tumors in women. Given the high prevalence of BC, brain metastasis (BM) arising from this malignancy are the second most frequent type among patients surpassed only by those from lung cancer. This expert consensus aims to standardize the management of BC brain metastases (BCBM) and improve patient outcomes; it serves as a practical, evidence-based guide for clinicians and allied specialists.</p><p><strong>Methods: </strong>An expert panel comprising specialists from disciplines including medical oncology, breast surgery, neurosurgery, and pathology was convened. In developing this expert consensus, the expert panel conducted a comprehensive literature review and referenced authoritative guidelines from both domestic and international sources.</p><p><strong>Results: </strong>With advancements of systemic therapies, an expanding array of medications has demonstrated efficacy against BCBM, especially among individuals with human epidermal growth factor receptor 2 (HER2)-positive BCBM. In this consensus, we systematically evaluate the following key components: clinical manifestations, imaging assessments, pathological diagnosis, treatment strategies, prognostic outcomes, follow-up and post-treatment monitoring.</p><p><strong>Conclusions: </strong>This updated consensus incorporates significant revisions across key domains-including pathological diagnosis, chemotherapy, anti-HER2 targeted therapy, and the sequencing of radiotherapy and systemic treatments-while introducing new recommendations on imaging surveillance criteria and frequency, other targeted agents, and the integration of systemic therapy with local modalities.</p>","PeriodicalId":101427,"journal":{"name":"Translational breast cancer research : a journal focusing on translational research in breast cancer","volume":"7 ","pages":"20"},"PeriodicalIF":1.4,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13187562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147990017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Datopotamab deruxtecan in Chinese patients with heavily pretreated advanced or metastatic triple-negative breast cancer in the phase I/II TROPION-PanTumor02 study.","authors":"Tao Wang, Yuping Sun, Wenyan Chen, Wei Li, Jing Cheng, Man Li, Zhongyu Yuan, Jun Qian, Kun Wang, Shu Wang, Huihua Xiong, Zhigang Yu, Xiaojia Wang, Chunjiao Wu, Micah J Maxwell, Biao Zhang, Chang Liu, Xiaoling Zeng, Zefei Jiang","doi":"10.21037/tbcr-2025-1-81","DOIUrl":"10.21037/tbcr-2025-1-81","url":null,"abstract":"<p><strong>Background: </strong>Despite recent improvements in treatment, outcomes for patients with pretreated, advanced triple-negative breast cancer (TNBC) remain poor. We present results from the phase I/II TROPION-PanTumor02 study of datopotamab deruxtecan (Dato-DXd), an antibody-drug conjugate (ADC) comprised of a humanised anti-trophoblast cell surface antigen 2 (TROP2) monoclonal antibody conjugated to a potent topoisomerase I (Topo-I) inhibitor, in Chinese patients with pretreated, advanced TNBC.</p><p><strong>Methods: </strong>Patients received Dato-DXd 6 mg/kg intravenously every 3 weeks until radiological progression or another discontinuation criterion was met. The primary endpoint was objective response rate (ORR) per independent central review (ICR); secondary endpoints included progression-free survival (PFS), overall survival (OS), and safety.</p><p><strong>Results: </strong>At data cutoff (6 May 2024), 79 patients had received treatment. Median age was 50.0 years (range, 33-73 years) and 74 (93.7%) patients had metastatic disease; 33 (41.8%) had liver metastases. Patients had received a median of 3 (range, 2‒8) prior lines of chemotherapy for advanced disease [≥5 lines, n=21 (26.6%)]. ORR by ICR was 33.8% [95% confidence interval (CI): 23.4-45.4%]. Median PFS and OS were 5.3 months (95% CI: 4.2-6.9) and 13.5 months [95% CI: 10.7-not calculable (NC)], respectively. The most common treatment-related adverse events (TRAEs) were stomatitis (49.4%) and nausea (43.0%). Twenty-five patients (31.6%) experienced grade ≥ III TRAEs. Adjudicated drug-related interstitial lung disease (ILD) was reported in 1 patient (grade II).</p><p><strong>Conclusions: </strong>Dato-DXd monotherapy demonstrated clinical activity and manageable safety in Chinese patients with heavily pretreated, advanced TNBC. Phase III studies of Dato-DXd alone or in combination in early-stage and advanced TNBC are ongoing.</p>","PeriodicalId":101427,"journal":{"name":"Translational breast cancer research : a journal focusing on translational research in breast cancer","volume":"7 ","pages":"11"},"PeriodicalIF":1.4,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13187552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147990000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chemotherapy-induced peripheral neuropathy in breast cancer: a narrative review.","authors":"Michael Brodsky, Mumtu Lalla, Sun Oh, Jesus D Anampa","doi":"10.21037/tbcr-25-41","DOIUrl":"10.21037/tbcr-25-41","url":null,"abstract":"<p><strong>Background and objective: </strong>Chemotherapy-induced peripheral neuropathy (CIPN) remains a major, unresolved complication of breast cancer therapy, often leading to treatment modifications and enduring functional impairment. This review addresses the complex pathogenesis of CIPN, as well as the clinical presentation and impact of CIPN on patient quality of life. The primary objective of this review is to highlight the pathophysiology and pathogenesis of CIPN, as well as detail current strategies and future targets to prevent and treat CIPN in breast cancer patients.</p><p><strong>Methods: </strong>We conducted a narrative review using the PubMed/Medline, Cochrane, and Embase databases from database inception to July 2025. We used keyword searches including 'breast cancer', 'chemotherapy-induced peripheral neuropathy/CIPN', 'taxane', 'taxane induced peripheral neuropathy/TIPN', 'platinum', 'alkaloids', 'antibody drug conjugates', 'CIPN prevention', 'CIPN treatment', 'biomarkers', 'microbiome', 'racial disparities', 'genetics', 'quality of life', 'inflammation'. Inclusion criteria included clinical and translational English-language studies addressing CIPN in breast cancer, CIPN biomarkers, and the microbiome in oncology research. Exclusion criteria included non-English language studies and clinical studies unrelated to breast cancer.</p><p><strong>Key content and findings: </strong>In this paper, we synthesize the pathophysiology of CIPN and the growing body of research implicating systemic inflammation and gut microbiome composition in modulating CIPN pathogenesis, suggesting a biological basis for interindividual variability in susceptibility. We also summarize emerging evidence on the role of racial disparities in CIPN. Finally, we explore commonly studied biomarkers that have shown promise as potential predictive markers of CIPN onset as well as potential therapeutic strategies.</p><p><strong>Conclusions: </strong>CIPN remains a common, dose-limiting toxicity in breast cancer care. Preventive strategies and symptomatic management with consistent clinical benefits are lacking. Duloxetine has strongest scientific evidence for pain reduction; other pharmacologic and non-pharmacologic approaches are promising but heterogeneous and should be framed as adjunctive. Biomarker driven trial designs that test anti-inflammatory strategies, as well as microbiome-targeted interventions, may accelerate treatment breakthroughs. Finally, attention to race as a factor in CIPN susceptibility can help to identify high-risk patients and reduce disparities in CIPN burden.</p>","PeriodicalId":101427,"journal":{"name":"Translational breast cancer research : a journal focusing on translational research in breast cancer","volume":"7 ","pages":"18"},"PeriodicalIF":1.4,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13187559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147990673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}