By Ana Espino | Published on October 29, 2025 | 3 min read
Triple-negative breast cancer (TNBC)
is an aggressive form of the disease, often diagnosed in young women, that does
not respond to hormone therapy or HER2-targeted treatments. Therapeutic options
are mainly limited to cytotoxic chemotherapy, which shows variable efficacy and
notable side effects. Among the available agents, capecitabine is widely
prescribed as adjuvant therapy or for recurrent disease, but its clinical
benefit varies considerably between patients.
One of the main challenges in TNBC
lies in its biological heterogeneity: molecular profiles differ greatly,
making it difficult to predict treatment response. In this context, identifying
reliable biomarkers to guide therapeutic decisions is essential.
This study was therefore initiated
to evaluate the potential of the transcription factor FOXC1 as a predictive
biomarker of response to capecitabine, by analyzing its expression in tumor
samples and correlating it with clinical outcomes.
Can FOXC1 predict who benefits from
capecitabine?
The study focused on a cohort of
patients with TNBC treated with capecitabine in the adjuvant or metastatic
setting. FOXC1 expression was assessed by immunohistochemistry on
tumor samples, then correlated with clinical response data, progression-free
survival (PFS), and overall survival (OS). This approach aimed to
explore the predictive value of FOXC1 in relation to capecitabine
efficacy.
The results showed that tumors with high
FOXC1 expression responded significantly better to capecitabine. These
patients demonstrated higher objective response rates, longer
response durations, and improved PFS and OS. The findings confirm
that FOXC1 expression is an independent predictive factor for response
to capecitabine, even after adjustment for other clinical variables.
Toward truly personalized
chemotherapy
Triple-negative breast cancer
remains an aggressive disease with a poor prognosis, few targeted treatment
options, and a high risk of relapse. One of the key current challenges is
identifying biomarkers that can guide chemotherapy use—helping to avoid
unnecessary treatments and optimize response rates.
In this context, the present study
evaluated FOXC1 expression as a predictive marker of capecitabine
efficacy in patients with TNBC treated in the adjuvant setting. The
analysis indicates that FOXC1 is a strong predictor of response to
capecitabine, independent of other clinical factors. It may influence tumor
sensitivity to this treatment, although the underlying mechanisms remain
unclear. This biomarker could therefore help
identify patients most likely to benefit from capecitabine, while sparing
others from ineffective therapy.
However, some limitations remain,
and further research is warranted. Additional studies—including prospective
validation, functional analyses of FOXC1, and stratified clinical
trials—are needed to confirm its value as a precision medicine tool
in TNBC.
Read next: Triple-negative: a new targeted weapon?
About the author – Ana EspinoPhD in Immunology, specialized in Virology
