Mortality is higher for Black patients receiving neoadjuvant chemo for breast cancer: Study

For patients with early-stage breast cancer treated with neoadjuvant chemotherapy (NACT), Blacks have higher mortality risk than Whites, according to a study published online Nov. 22 in JAMA Network Open.

Arya Mariam Roy, M.D., from the Roswell Park Comprehensive Cancer Center in Buffalo, New York, and colleagues examined racial and ethnic disparities in chemosensitivity and the association with survival in patients with early-stage breast cancer. Participants included 103,605 patients (68.7% white) with clinical stage I to III breast cancer treated with NACT. In 43.2%, 34.4%, and 22.4% of patients, breast cancer was refractory, sensitive, and very sensitive, respectively.

The researchers found that patients had more refractory disease in the hormone receptor-positive ERBB2-negative (formerly HER2-negative) group, regardless of race or ethnicity. Black patients had a lower percentage of very sensitive disease among those with ERBB2-positive disease (32% versus 37% to 40%), and Blacks had more refractory disease compared with other races and ethnicities among those with triple-negative breast cancer (38% versus 30% to 35%). In the overall cohort, Black patients had increased mortality compared with white patients in refractory and sensitive disease (hazard ratios, 1.53 and 1.25, respectively). Compared with White patients, Asians had lower mortality risk in refractory, sensitive, and very sensitive disease groups (hazard ratios, 0.71, 0.58, and 0.60, respectively).

"Our findings may have important implications in the design and development of future research to personalize treatment options for patients with breast cancer to improve efficacy and reduce toxic effects," the authors write.

One author disclosed ties to the biopharmaceutical industry.