Lack of racial differences in clinical outcomes of breast cancer patients receiving neoadjuvant chemotherapy: a single academic center study

• Published in: Breast cancer research and treatment Vol. 192; no. 2; pp. 411 - 421
• Main Authors: Sarma, Maithreyi, Perimbeti, Stuthi, Nasir, Samar, Attwood, Kristopher, Kapoor, Ankita, O’Connor, Tracey, Early, Amy, Levine, Ellis G., Takabe, Kazuaki, Kalinski, Pawel, Ambrosone, Christine, Khoury, Thaer, Yao, Song, Gandhi, Shipra
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.04.2022; Springer; Springer Nature B.V
• Subjects: Adjuvant treatment; African Americans; Black or African American - genetics; Breast cancer; Breast Neoplasms - drug therapy; Breast Neoplasms - genetics; Cancer; Cancer patients; Cancer research; Care and treatment; Chemotherapy; Clinical outcomes; Epidemiology; ErbB-2 protein; Ethnicity; Female; Genetic diversity; Humans; Medicine; Medicine & Public Health; Neoadjuvant Therapy; Oncology; Oncology, Experimental; Patient outcomes; Patients; Race Factors; Racial differences; Regression analysis; Statistical analysis; Survival; United States; United States; Neoadjuvant chemotherapy; Breast cancer; Racial disparity; Clinical outcomes
• ISSN: 0167-6806; 1573-7217
• DOI: 10.1007/s10549-021-06506-y

Purpose To examine the association between race and clinical outcomes (pathological complete response [pCR]; recurrence-free survival [RFS], and overall survival [OS]) in patients diagnosed with triple-negative (TNBC) or HER2-positive breast cancer treated with neoadjuvant chemotherapy (NAC). Methods Patients who self-identified as non-Hispanic white (NHW) or non-Hispanic Black (NHB) and were diagnosed with Stage I–III TNBC ( n  = 171 including 124 NHW and 47 NHB) and HER2-positive ( n  = 161 including 136 NHW and 25 NHB) breast cancer who received NAC from 2000 to 2018 at Roswell Park Comprehensive Cancer Center were included. Associations of race with pCR and survival outcomes were evaluated using logistic and Cox regression models, respectively. Results There was no statistically significant difference in pCR between NHB and NHW patients with TNBC (31.9 vs 29.8%; OR: 1.11, 95% CI 0.54–2.29) or HER2-positive breast cancer (36.0 vs 39.7%; OR: 0.87, 95% CI 0.36–3.11). After controlling for potential confounders, including age, stage, treatment regimens, insurance status, and comorbidities, no statistically significant difference in OS or RFS was observed between NHB and NHW patients within either subtype. Conclusion TNBC or HER2-positive breast cancer patients treated at a single academic center in Buffalo, NY, showed similar outcomes independent of patients’ race. Given the known genetic diversity of African American ancestry in the US, further studies investigating the interplay between race, geography, and clinical outcomes are warranted.