A retrospective cohort study conducted by Maggie L. DiNome, MD, and colleagues from Duke University School of Medicine revealed significant variations in the odds of achieving pathologic complete response (pCR) and improved overall survival (OS) among patients with triple-negative breast cancer (TNBC) who underwent neoadjuvant chemotherapy. The study found that Black women with TNBC were less likely to achieve pCR compared to white women, while Hispanic women had higher odds of achieving pCR. The unadjusted OS was significantly higher in patients who achieved pCR, regardless of race/ethnicity, suggesting the importance of this treatment outcome. However, after adjusting for various factors, Black race was not associated with worse OS, while Hispanic and Asian race/ethnicity were linked to improved OS.
Biological Factors and Treatment Response
The authors emphasized the need to understand the underlying influences, including biological factors, contributing to the observed differences in treatment outcomes based on race/ethnicity. Dr. DiNome highlighted the importance of recognizing that TNBCs may exhibit varying responses to standard treatments among different racial groups. The study highlighted the significance of further research to develop more effective therapies tailored to patients with TNBC, especially those belonging to racial minorities.
An interesting finding from the study was that both Black and Hispanic women experienced a delay in starting therapy compared to white women. This delay, however, did not fully explain the disparities in treatment outcomes observed among different racial groups. Dr. DiNome suggested that inherent biological factors may play a significant role in determining treatment responses, underscoring the need to explore these biological differences further. The study served as a hypothesis-generating investigation, highlighting the need to delve deeper into the reasons behind the differences in treatment responses based on race/ethnicity.
The study utilized data from a sizable cohort of patients with stage I-III TNBC to shed light on the racial disparities in treatment outcomes. While age and income level were associated with improved OS, government insurance, higher tumor grade, larger tumor size, and lymph node positivity were linked to worse OS. The findings underscore the urgency of developing personalized treatment approaches that account for the biological and racial differences influencing treatment responses in patients with TNBC. Dr. DiNome stressed the importance of exploring these differences further and devising strategies to address them effectively in future oncological research.
The study’s insights into the racial disparities in TNBC treatment outcomes highlight the complex interplay between biological factors, treatment responses, and racial/ethnic backgrounds. By acknowledging these disparities and conducting further research to elucidate the underlying mechanisms, oncologists and researchers can strive towards developing more targeted and effective treatment strategies for all patients affected by this aggressive breast cancer subtype.