RecurIndex-derived molecular features associated with total pathological complete response in triple-negative breast cancer: An exploratory prospective cohort study with single-cell transcriptomic contextualization.

BACKGROUND

Reliable biomarkers for predicting neoadjuvant chemotherapy (NAC) response in triple-negative breast cancer (TNBC) remain limited. We explored whether RecurIndex-derived molecular features were associated with total pathological complete response (tpCR).

METHODS

Seventy-four patients with TNBC treated with dose-dense NAC were analyzed. Associations between RecurIndex risk scores, 18 core genes, and tpCR were assessed using logistic regression and ROC analyses. Clinical-molecular models were internally validated by bootstrap resampling. Public single-cell RNA-seq data were used for biological contextualization.

RESULTS

Twenty-nine patients (39.2%) achieved tpCR. The distant recurrence score, was significantly associated with tpCR. OBSL1, BLM, and CCR1 were identified as candidate tpCR-associated genes. The model combining OBSL1, BLM, and clinical nodal stage achieved an AUC of 0.838 and an optimism-corrected AUC of 0.799.

CONCLUSIONS

RecurIndex-derived molecular features were associated with tpCR in TNBC. These exploratory findings warrant validation in independent cohorts.