Abstract GS4-07: Race, ethnicity and clinical outcomes in hormone receptor-positive, HER2-negative, node-negative breast cancer: results from the TAILORx trial

Albain, Kathy S.; Gray, R; Sparano, J. A.; Makower, DF; Pritchard, KI; Hayes, DF; Geyer, CE; Dees, E. Claire; Goetz, Matthew Bidwell; Olson, JA; Lively, Tracy; Badve, S; Saphner, T; Wagner, LI; Whelan, Timothy J.; Ellis, MJ; Paik, Soon Young; Wood, W. C.; Ravdin, P.; Keane, MM; Gómez, H; Reddy, P. Ravikumar; Goggins, TF; Mayer, IA; Brufsky, AM; Toppmeyer, D.; Kaklamani, VG; Jl, Berenberg; Abrams, J.S.; Sledge, G. W.

doi:10.1158/1538-7445.sabcs18-gs4-07

Cited by 11 publications

(8 citation statements)

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“…The distribution of Oncotype DX scores did not differ significantly between black and white women in our study (P = .9). This is consistent with the data presented by Albain et al 36 at the 41st Annual San Antonio Breast Cancer Symposium (December 4-8, 2018; San Antonio, Texas), which consisted of race-stratified results from the Trial Assigning Individualized Options for Treatment (TAILORx) and showed that although recurrence scores were similar in black and white women, despite comparable adjuvant systemic therapy, black women had worse outcomes.…”

Section: Discussionsupporting

confidence: 89%

Does race predict survival for women with invasive breast cancer?

Walsh

Zabor

Stempel

et al. 2019

Cancer

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BACKGROUND: Black women with breast cancer have lower survival rates and higher recurrence rates in comparison with white women. This study compared treatment and survival outcomes for black and white women at a highly specialized tertiary care cancer center. METHODS: An institutional review board-approved, retrospective institutional database review was performed to identify all black women treated for invasive breast cancer between 2005 and 2010. Women with a prior history of breast cancer, stage IV cancer, or bilateral breast cancer were excluded. White women had similar exclusion criteria applied and were then matched to black women 1:1 by age and diagnosis year. Clinicopathologic and treatment variables were compared by race. Kaplan-Meier methodology was used to estimate overall survival (OS) and disease-free survival (DFS); a multivariable analysis was conducted with Cox regression models. RESULTS: The study group consisted of 1332 women (666 black). The median tumor size was larger in black women (1.6 vs 1.3 cm; P < .001). Black women had more nodal disease (41.1% vs 32%; P < .001) and had tumors that were more frequently an estrogen receptor-negative (32.9% vs 15%; P < .001), progesterone receptor-negative (47.1% vs 30.2%; P < .001), or triple-negative (TN) subtype (24% vs 8.9%; P < .001) in comparison with white women. Black women also had inferior DFS and OS; race was not an independent prognostic indicator in the multivariable analysis. CONCLUSIONS: Black women had more advanced disease and adverse prognostic indicators at diagnosis, but race was not an independent predictor of outcome. Black women were significantly more likely to have TN breast cancer. Further research is necessary to understand the differences in tumor biology associated with race. Cancer 2019;125:3139-3146.

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Section: Discussionsupporting

confidence: 89%

Does race predict survival for women with invasive breast cancer?

Walsh

Zabor

Stempel

et al. 2019

Cancer

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“…Molecular assays (eg, a loss of heterozygosity) are more reliable approaches for showing clonal relationships between original tumors and ipsilateral IBCs and for distinguishing genetically related recurrences from genetically distinct new primaries. Using commonly used definitions of intermediate (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) and high recurrence risks (≥31) generated a similar result. The 21-gene recurrence score is an assay based on reverse transcription-polymerase chain reaction that is currently applied to early-stage, ER+ IBC to assess the prognosis and the likely benefit from chemotherapy in addition to endocrine therapy.…”

Section: Discussionmentioning

confidence: 63%

“…29 Using the TAILORxdefined cutoff value of 26,19 we observed that black patients with DCIS were more likely than white counterparts to subsequently develop aggressive ER+ IBC. Using commonly used definitions of intermediate (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) and high recurrence risks (≥31) generated a similar result. This finding was consistent with the racial difference in RNA expression-based recurrence scores reported for first primary IBC.…”

Section: Discussionmentioning

confidence: 63%

“…The 21-gene recurrence score is an assay based on reverse transcription-polymerase chain reaction that is currently applied to early-stage, ER+ IBC to assess the prognosis and the likely benefit from chemotherapy in addition to endocrine therapy. 30 Our finding needs to be confirmed in future studies with a larger number of black patients with DCIS who have 21-gene assay results for subsequent IBC. Using commonly used definitions of intermediate (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) and high recurrence risks (≥31) generated a similar result.…”

Section: Discussionmentioning

confidence: 66%

“…[13][14][15] A recent analysis of TAILORx trial data (including 8189 whites, 693 blacks, 405 Asians, and 432 others) showed a similar distribution of recurrence scores across race groups in patients with early-stage, hormone receptor-positive, HER2-IBC (with no prior diagnosis of DCIS) and worse survival for black patients. 30 Our finding needs to be confirmed in future studies with a larger number of black patients with DCIS who have 21-gene assay results for subsequent IBC.…”

Section: Discussionmentioning

confidence: 66%

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Race and risk of subsequent aggressive breast cancer following ductal carcinoma in situ

Liu

West

Weber

et al. 2019

Cancer

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Background General populations of black women have a higher risk of developing breast cancer negative for both estrogen receptor (ER) and progesterone receptor (PR) in comparison with white counterparts. Racial differences remain unknown in the risk of developing aggressive invasive breast cancer (IBC) that is characterized by negativity for both ER and PR (ER–PR–) or higher 21‐gene recurrence scores after ductal carcinoma in situ (DCIS). Methods This study identified 163,892 women (10.5% black, 9.8% Asian, and 8.6% Hispanic) with incident DCIS between 1990 and 2015 from the Surveillance, Epidemiology, and End Results data sets. Cox proportional hazards regression was used to estimate hazards ratios (HRs) of subsequent IBC classified by the hormone receptor status and 21‐gene recurrence scores. Results During a median follow‐up of 90 months, 8333 women developed IBC. In comparison with white women, the adjusted HR of subsequent ER–PR– breast cancer was 1.86 (95% confidence interval [CI], 1.57‐2.20) for black women (absolute 10‐year difference, 2.2%) and 1.40 (95% CI, 1.14‐1.71) for Asian women (absolute 10‐year difference, 0.4%); this was stronger than the associations for ER+ and/or PR+ subtypes (Pheterogeneity = .0004). The 21‐gene recurrence scores of subsequent early‐stage, ER+ IBCs varied by race/ethnicity (Pheterogeneity = .057); black women were more likely than white women to have a recurrence score of 26 or higher (HR, 1.38; 95% CI, 1.00‐1.92). No significant difference was observed in the risks of subsequent IBC subtypes for Hispanic women. Conclusions Black and Asian women with DCIS had higher risks of developing biologically aggressive IBC than white counterparts. This should be considered in treatment decisions for black and Asian patients with DCIS.

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