Triple-negative breast cancer (TNBC) is one of the most difficult subtypes of breast cancer to treat due to its distinct clinical and molecular characteristics. Patients with TNBC face a high recurrence rate, an increased risk of metastasis, and lower overall survival compared to other breast cancer subtypes. Despite advancements in targeted therapies, traditional chemotherapy (primarily using platinum compounds and taxanes) continues to be the standard treatment for TNBC, often with limited long-term efficacy. TNBC tumors are heterogeneous, displaying a diverse mutation profile and considerable chromosomal instability, which complicates therapeutic interventions. The development of chemoresistance in TNBC is frequently associated with the process of epithelial–mesenchymal transition (EMT), during which epithelial tumor cells acquire a mesenchymal-like phenotype. This shift enhances metastatic potential, while simultaneously reducing the effectiveness of standard chemotherapeutics. It has also been suggested that EMT plays a central role in the development of cancer stem cells. Hence, there is growing interest in exploring small-molecule inhibitors that target the EMT process as a future strategy for overcoming resistance and improving outcomes for patients with TNBC. This review focuses on the progression and drug resistance of TNBC with an emphasis on the role of EMT in these processes. We present TNBC-specific and EMT-related molecular features, key EMT protein markers, and various signaling pathways involved. We also discuss other important mechanisms and factors related to chemoresistance in TNBC within the context of EMT, highlighting treatment advancements to improve patients’ outcomes.
三阴性乳腺癌（TNBC）因其独特的临床和分子特征，成为乳腺癌中最难治疗的亚型之一。与其他乳腺癌亚型相比，TNBC患者面临高复发率、高转移风险和较低的总生存率。尽管靶向治疗取得进展，传统化疗（主要使用铂类药物和紫杉烷类）仍是TNBC的标准治疗方案，但其长期疗效往往有限。TNBC肿瘤具有高度异质性，表现出多样化的突变谱和显著的染色体不稳定性，这使治疗干预变得复杂。TNBC化疗耐药性的形成常与上皮-间质转化（EMT）过程相关，在此过程中上皮性肿瘤细胞获得间质样表型。这种转变增强了转移潜能，同时降低了标准化疗药物的疗效。研究还表明EMT在癌症干细胞形成过程中发挥核心作用。因此，针对EMT过程的小分子抑制剂作为克服耐药性、改善TNBC患者预后的未来策略，正受到越来越多的关注。本综述聚焦TNBC的进展和耐药机制，重点探讨EMT在这些过程中的作用。我们阐述了TNBC特异性及EMT相关的分子特征、关键EMT蛋白标志物以及涉及的各种信号通路。同时，在EMT框架下讨论了TNBC化疗耐药的其他重要机制和因素，并着重介绍了改善患者预后的治疗进展。
肿瘤(癌症)患者之家