A retrospective study showed that UNC0379 taxane-first sequencing of adjuvant treatment was associated with lower risk of relapse and death. A prospective RCT was designed to determine whether taxane-first sequencing regimen for NAT was able to improve pCR rate in breast cancer patients. However, for TNBC patients included in our meta-analysis, the taxane-first regimen did not significantly improve the pCR rate, although this may be due to the efficacy Cell Counting Kit-8 difference within molecular subtypes and the relatively small number of included patients. NAT is an ideal platform to test the response and chemosensitivity in vivo, thus guiding further treatment. Two parallel studies from the GeparTiro trial showed that the response-guided regimens could not obtain a higher pCR rate than the standard. Furthermore, follow-up data demonstrated there was a survival advantage in Luminal A and Luminal B subtypes but not in triple negative or HER2+ subtypes among patients treated with response-guided regimens The main reason may be due to the low pCR rate difference in TNBC patients, which was also confirmed in our study. Several limitations in our meta-analysis should be discussed. Firstly, a majority of included studies were from subgroup data in RCTs, leading to insufficient details of patient characteristics and toxicity for TNBC patients. Our meta-analysis was not able to determine which TNBC subgroup of TNBC could derive more benefit from the testing regimen and whether new agents would increase the chance of severe side events. Additionally, we included several studies which were only published as abstracts. This could be associated with the Tower of Babel bias, meaning that positive results would be highly presented in international conferences and negative studies left out. Furthermore, the 262 factorial study in our meta-analysis was considered as two independent paired regimens, perhaps leading to the cross-talk treatment efficacy interaction. Moreover, the I-SPY2 trial also concurrently used veliparib with carboplatin in the testing group, which could overestimate carboplatin efficacy.