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Racial/Ethnic Disparities in Pathologic Complete Response and Overall Survival in Patients With Triple-Negative Breast Cancer Treated With Neoadjuvant Chemotherapy.

Publication ,  Journal Article
Woriax, HE; Thomas, SM; Plichta, JK; Rosenberger, LH; Botty van den Bruele, A; Chiba, A; Hwang, ES; DiNome, ML
Published in: J Clin Oncol
May 10, 2024

PURPOSE: Black women have higher rates of death from triple-negative breast cancer (TNBC) than White women. We hypothesized that pathologic complete response (pCR) to neoadjuvant chemotherapy (NAC) and overall survival (OS) may vary by race/ethnicity in patients with TNBC. METHODS: We identified women 18 years and older with stage I-III TNBC who received NAC followed by surgery from the National Cancer Database (2010-2019). We excluded patients without race/ethnicity or pathology data. Primary outcomes were pCR rates and OS on the basis of race/ethnicity. RESULTS: Forty thousand eight hundred ninety women with TNBC met inclusion criteria (median age [IQR], 53 [44-61] years): 26,150 Non-Hispanic White (64%, NHW), 9,672 Non-Hispanic Black (23.7%, NHB), 3,267 Hispanic (8%), 1,368 Non-Hispanic Asian (3.3%, NHA), and 433 Non-Hispanic Other (1.1%, NHO) patients. Overall, 29.8% demonstrated pCR (NHW: 30.5%, NHB: 27%, Hispanic: 32.6%, NHA: 28.8%, NHO: 29.8%). Unadjusted OS was significantly higher for those with pCR compared with those with residual disease (5-year OS, 0.917 [95% CI, 0.911 to 0.923] v 0.667 [95% CI, 0.661 to 0.673], log-rank P < .001), and this association persisted after adjustment for demographic and tumor factors. The effect of achieving pCR on OS did not differ by race/ethnicity (interaction P = .10). However, NHB patients were less likely (odds ratio [OR], 0.89 [95% CI, 0.83 to 0.95], P = .001) and Hispanic patients were more likely (OR, 1.19 [95% CI, 1.08 to 1.31], P = .001) to achieve pCR than NHW patients. After adjustment for patient and disease factors, including achievement of pCR, Hispanic (hazard ratio [HR], 0.76 [95% CI, 0.69 to 0.85], P < .001) and NHA (HR, 0.64 [95% CI, 0.55 to 0.75], P < .001) race/ethnicity remained associated with OS. CONCLUSION: Odds of achieving pCR and OS in patients with TNBC appear to be associated with race/ethnicity. Additional research is necessary to understand how race/ethnicity is associated with rates of pCR and OS, whether related to socioeconomic factors or biologic variables, or both.

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Published In

J Clin Oncol

DOI

EISSN

1527-7755

Publication Date

May 10, 2024

Volume

42

Issue

14

Start / End Page

1635 / 1645

Location

United States

Related Subject Headings

  • White People
  • White
  • Triple Negative Breast Neoplasms
  • Racial Groups
  • Pathologic Complete Response
  • Oncology & Carcinogenesis
  • Neoadjuvant Therapy
  • Middle Aged
  • Humans
  • Hispanic or Latino
 

Citation

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Woriax, H. E., Thomas, S. M., Plichta, J. K., Rosenberger, L. H., Botty van den Bruele, A., Chiba, A., … DiNome, M. L. (2024). Racial/Ethnic Disparities in Pathologic Complete Response and Overall Survival in Patients With Triple-Negative Breast Cancer Treated With Neoadjuvant Chemotherapy. J Clin Oncol, 42(14), 1635–1645. https://doi.org/10.1200/JCO.23.01199
Woriax, Hannah E., Samantha M. Thomas, Jennifer K. Plichta, Laura H. Rosenberger, Astrid Botty van den Bruele, Akiko Chiba, E Shelley Hwang, and Maggie L. DiNome. “Racial/Ethnic Disparities in Pathologic Complete Response and Overall Survival in Patients With Triple-Negative Breast Cancer Treated With Neoadjuvant Chemotherapy.J Clin Oncol 42, no. 14 (May 10, 2024): 1635–45. https://doi.org/10.1200/JCO.23.01199.
Woriax HE, Thomas SM, Plichta JK, Rosenberger LH, Botty van den Bruele A, Chiba A, et al. Racial/Ethnic Disparities in Pathologic Complete Response and Overall Survival in Patients With Triple-Negative Breast Cancer Treated With Neoadjuvant Chemotherapy. J Clin Oncol. 2024 May 10;42(14):1635–45.
Woriax, Hannah E., et al. “Racial/Ethnic Disparities in Pathologic Complete Response and Overall Survival in Patients With Triple-Negative Breast Cancer Treated With Neoadjuvant Chemotherapy.J Clin Oncol, vol. 42, no. 14, May 2024, pp. 1635–45. Pubmed, doi:10.1200/JCO.23.01199.
Woriax HE, Thomas SM, Plichta JK, Rosenberger LH, Botty van den Bruele A, Chiba A, Hwang ES, DiNome ML. Racial/Ethnic Disparities in Pathologic Complete Response and Overall Survival in Patients With Triple-Negative Breast Cancer Treated With Neoadjuvant Chemotherapy. J Clin Oncol. 2024 May 10;42(14):1635–1645.

Published In

J Clin Oncol

DOI

EISSN

1527-7755

Publication Date

May 10, 2024

Volume

42

Issue

14

Start / End Page

1635 / 1645

Location

United States

Related Subject Headings

  • White People
  • White
  • Triple Negative Breast Neoplasms
  • Racial Groups
  • Pathologic Complete Response
  • Oncology & Carcinogenesis
  • Neoadjuvant Therapy
  • Middle Aged
  • Humans
  • Hispanic or Latino