Risk prediction in early triple negative breast cancer

Multigene RNA signature signals benefit from intensified chemotherapy for a high risk group Triple negative breast cancer is an aggressive subtype of breast cancer characterised by a lack of oestrogen, progesterone, and HER2 receptors which, if present, would guide the use of targeted therapies. This disease lacks validated prospective biomarkers predicting response to treatment and outcomes beyond basic staging information. The traditional mainstay of systemic treatment for triple negative breast cancer has been chemotherapy. We need to develop methods to guide treatment decisions in an increasingly complex therapeutic landscape in operable triple negative breast cancer. Enhanced understanding of risk of recurrence and sensitivity to treatment, as is the aim of the linked randomised trial by He and colleagues (BCTOP-T-A01) (doi:10.1136/bmj-2024-079603),1 can inform decisions about who needs intensive treatment and who might be spared therapies with serious and often permanent toxicities. The BCTOP-T-A01 trial is the first to prospectively validate a multigene tumour RNA signature to guide choice of chemotherapy in patients with early triple negative breast cancer.1 This …