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

K. Albain, R. Gray, J. Sparano, D. Makower, K. Pritchard, D. Hayes, C. Geyer, E. Dees, Mp Goetz, J. Olson, T. Lively, S. Badve, T. Saphner, Lindsay Wagner, T. Whelan, M. Ellis, S. Paik, W. Wood, P. Ravdin, M. Keane, H. Gómez, P. Reddy, T. Goggins, I. Mayer, A. Brufsky, D. Toppmeyer, V. Kaklamani, J. Berenberg, J. Abrams, G. Sledge
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引用次数: 13

Abstract

Background: Black race is associated with worse outcomes in localized hormone receptor (HR)-positive breast cancer in population-based and in clinical trial cohorts, whether using self-identified race (Albain et al. JNCI 2009 [PMID: 19584328; Sparano et al. JNCI 2012 [PMID: 22250182) or genetically-identified race (Schneider et al. J Precision Oncol 2017 [PMID: 29333527]). This disparity persists after adjustment for treatment delivery parameters (Hershman et al. JCO 2009 [PMID:19307504]). We evaluated clinicopathologic characteristics, treatment delivered and clinical outcomes in the Trial Assigning Individualized Options for Treatment (TAILORx) by race and ethnicity (Sparano et al. NEJM 2018 [PMID: 29860917]). Methods: The analysis included 9719 evaluable TAILORx participants. The association between clinical outcomes and race (white, black, Asian, other/unknown) and ethnicity (Hispanic vs. non-Hispanic) was examined, including invasive disease-free survival (iDFS), distant relapse-free interval (DRFI), relapse-free interval (RFI), and overall survival (OS). Proportional hazards models were fit including age (5 categories), tumor size (>2 cm vs. Results: The study population included 8189 (84%) whites, 693 (7%) blacks, 405 (4%) Asians, and 432 (4%) with other/unknown race. Regarding ethnicity, 7635 (79%) were non-Hispanic, 889 (9%) Hispanic, and 1195 (12%) unknown. There was no significant difference in RS distribution (p=0.22) in blacks compared with whites, or in median (17 vs. 17) or mean RS (19.1 vs. 18.2). There was likewise no difference in Hispanic vs. non-Hispanic ethnicity for RS distribution (p=0.72) or median (17 vs. 17) or mean RS (18.5 vs. 18.0). Black race (39% vs. 30%) and Hispanic ethnicity (39% vs. 30%) were both associated with younger age ( Conclusions: In patients eligible and selected for participation in TAILORx, black women had worse clinical outcomes despite similar 21-gene assay RS results and comparable systemic therapy. This adds to an emerging body of evidence suggesting a biologic basis or other factors contributing to racial disparities in HR-positive breast cancer that requires further evaluation. Citation Format: Albain K, Gray RJ, Sparano JA, Makower DF, Pritchard KI, Hayes DF, Geyer, Jr. CE, Dees EC, Goetz MP, Olson, Jr. JA, Lively T, Badve SS, Saphner TJ, Wagner LI, Whelan TJ, Ellis MJ, Paik S, Wood WC, Ravdin PM, Keane MM, Gomez HL, Reddy PS, Goggins TF, Mayer IA, Brufsky AM, Toppmeyer DL, Kaklamani VG, Berenberg JL, Abrams J, Sledge, Jr. GW. Race, ethnicity and clinical outcomes in hormone receptor-positive, HER2-negative, node-negative breast cancer: results from the TAILORx trial [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr GS4-07.
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GS4-07:种族、民族和激素受体阳性、her2阴性、淋巴结阴性乳腺癌的临床结局:来自TAILORx试验的结果
背景:在以人群为基础和临床试验队列中,黑人与局部激素受体(HR)阳性乳腺癌的预后较差相关,无论使用的是自我认定的种族(Albain等)。[qh] 2009 [mid: 19584328;Sparano等人。JNCI 2012 [PMID: 22250182]或基因鉴定的种族(Schneider等)。[J] .中国精密工程学报,2017。在调整治疗输送参数后,这种差异仍然存在(Hershman等)。Jco 2009 [mid:19307504])。我们在按种族和民族分配个体化治疗方案(TAILORx)的试验中评估了临床病理特征、提供的治疗和临床结果(Sparano等)。Nejm 2018[中值:29860917])。方法:纳入9719名可评价的TAILORx受试者。研究了临床结果与种族(白人、黑人、亚洲人、其他/未知种族)和种族(西班牙裔与非西班牙裔)之间的关系,包括侵袭性无病生存期(iDFS)、远端无复发间期(DRFI)、无复发间期(RFI)和总生存期(OS)。拟合的比例风险模型包括年龄(5类)、肿瘤大小(>2 cm)与结果:研究人群包括8189名(84%)白人、693名(7%)黑人、405名(4%)亚洲人和432名(4%)其他/未知种族。关于种族,7635人(79%)为非西班牙裔,889人(9%)为西班牙裔,1195人(12%)未知。黑人和白人的RS分布无显著差异(p=0.22),中位RS(17比17)和平均RS(19.1比18.2)也无显著差异。同样,西班牙裔与非西班牙裔的RS分布(p=0.72)、中位RS (17 vs. 17)或平均RS (18.5 vs. 18.0)也没有差异。黑人种族(39%对30%)和西班牙裔种族(39%对30%)都与较年轻的年龄相关(结论:在符合条件并选择参加TAILORx的患者中,黑人女性的临床结果较差,尽管有类似的21基因测定RS结果和类似的全身治疗。这增加了一个新出现的证据体,表明生物学基础或其他因素导致hr阳性乳腺癌的种族差异,需要进一步评估。引用格式:Albain K, Gray RJ, Sparano JA, Makower DF, Pritchard KI, Hayes DF, Geyer, Jr CE, des EC, Goetz MP, Olson, Jr. JA, Lively T, Badve SS, Saphner TJ, Wagner LI, Whelan TJ, Ellis MJ, Paik S, Wood WC, Ravdin PM, Keane MM, Gomez HL, Reddy PS, Goggins TF, Mayer IA, Brufsky AM, Toppmeyer DL, Kaklamani VG, Berenberg JL, Abrams J, Sledge, Jr GW。种族、民族和激素受体阳性、her2阴性、淋巴结阴性乳腺癌的临床结局:来自TAILORx试验的结果[摘要]。2018年圣安东尼奥乳腺癌研讨会论文集;2018年12月4-8日;费城(PA): AACR;癌症杂志,2019;79(4增刊):摘要nr GS4-07。
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