In a study reported in the Journal of Clinical Oncology, Woriax et al identified racial/ethnic differences in pathologic complete response rates and overall survival among women with triple-negative breast cancer who received neoadjuvant chemotherapy.
Study Details
The study involved data from the National Cancer Database on women aged ≥ 18 years with stage I to III triple-negative breast cancer who received neoadjuvant chemotherapy followed by surgery from 2010 to 2019. Women without race/ethnicity or pathology data were excluded from analysis. The primary outcome measures were pathologic complete response rates and overall survival on the basis of race/ethnicity.
Key Findings
A total of 40,890 women were included in the analysis; 64% were White, 23.7% Black, 8% Hispanic, 3.3% Asian, and 1.1% other race/ethnicity. Pathologic complete response was achieved in 29.8% of all patients, including 30.5% of White, 27% of Black, 32.6% of Hispanic, 28.8% of Asian, and 29.8% of patients of other race/ethnicity. Black patients were less likely (odds ratio [OR] = 0.89, 95% confidence interval [CI] = 0.83–0.95, P = .001) and Hispanic patients were more likely (OR = 1.19, 95% CI = 1.08–1.31, P = .001) to achieve pathologic complete response than White patients.
Overall survival at 5 years was 91.7% (95% CI = 91.1%–92.3%) among patients with pCR vs 66.7% (95% CI = 66.1%–67.3%) among those with residual disease (P < .001). The effect of achieving pathologic complete response on overall survival did not differ by race/ethnicity (interaction P = .10). Among patients with pathologic complete response, 5-year overall survival was similar between Black patients and White patients (91% vs 91.6%), whereas rates appeared to be somewhat higher among Hispanic patients (93.7%) and Asian patients (94%).
In analysis adjusting for patient and disease factors, including achievement of pathologic complete response, Hispanic patients (hazard ratio [HR] = 0.76, 95% CI = 0.69–0.85, P < .001) and Asian patients (HR = 0.64, 95% CI = 0.55–0.75, P < .001) had improved overall survival compared with White patients.
The investigators concluded, “Odds of achieving pathologic complete response and overall survival in patients with triple-negative breast cancer appear to be associated with race/ethnicity. Additional research is necessary to understand how race/ethnicity is associated with rates of pathologic complete response and overall survival, whether related to socioeconomic factors or biologic variables, or both.”
Maggie L. DiNome, MD, of the Division of Surgical Oncology, Duke University School of Medicine, is the corresponding author for the Journal of Clinical Oncology article.
Disclosure: The study was supported by a grant from the National Cancer Institute. For full disclosures of the study authors, visit ascopubs.org.
