Early Chemotherapy Less Beneficial in Black Women With Breast Cancer

Black women with breast cancer treated with early chemotherapy fare worse than women of other minority groups. These findings were published in the Journal of Clinical Oncology (doi:10.1200/JCO.2015.63.7801).

Breast cancer is more often at an advanced stage at diagnosis in black women, as well as in Hispanic and Asian women, than in white women. Hence, black women are more likely to receive neoadjuvant chemotherapy in hopes of improving outcomes for these women.

"Even when we controlled for the fact that minority women often present with more advanced-stage, higher-grade tumors, and more aggressive types of breast cancer overall, our team was surprised to find that black women did not respond as well to neoadjuvant chemotherapy compared to other racial groups," said Brigid Killelea, associate professor of surgery (oncology) at Yale School of Medicine in New Haven, Connecticut, and the first author of the study.

For the study, researchers used the National Cancer Database to explore racial disparities in the use of, and response to, neoadjuvant chemotherapy in 27 300 women with stage I-III cancer, Killelea reported.

While the cause of this worse response in black women is not known, researchers suspect biologic differences in chemosensitivity, disparities in treatment, or socioeconomic factors that cannot be adjusted for in the study are factors.

Donald Lannin, MD, professor of surgery (oncology) and senior author on the study, said the findings should stimulate deeper research.

A next step, explained Lannin, should be to determine which drugs will generate a response in black women. Furthermore, researchers will need to enroll enough black women in future clinical trials to ensure that these patients benefit equally from new drugs.

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