New Research Shows That Chemotherapy Outcomes May Differ By Race
Michelle Milliken
Triple-negative breast cancer (TNBC) is an aggressive form of the disease that lacks the three receptors or proteins that can be targeted with treatment (estrogen, progesterone, or HER2 protein). This means patient outcomes aren’t always as good. TNBC is more common among Black women, and research has shown that they’re more apt to die from the disease than white patients. While they may be less apt to get surgery and chemotherapy, as well, could chemotherapy itself not be as effective for this population? A new study shows it may not be.
Researchers at Duke Cancer Institute recently investigated chemo outcomes by race among nearly 41,000 women who were diagnosed with stage I-III TNBC between 2010 and 2019 and who had undergone chemo and surgery. They looked specifically at which percentage of women had pathologic complete responses to chemo, along with their survival odds.
Dr. Maggie DiNome, study co-author from the Duke Cancer Institute, says, “The purpose of our study was to look and see if there were any differences in response to treatment based on race, because we’ve seen that there’s differences in outcomes in patients.”
According to their findings, published in the Journal of Clinical Oncology, Black women had the lowest rate of pathologic complete response to chemo, at 27%. Hispanic patients had the highest rate – 32.6%, while white patients were at 30.5% and Asian patients had a 28.8% rate. The study also showed that survival was significantly higher in those who had a complete response, and survival didn’t seem to be impacted by race among those who had such a response.
The researchers say that going forward, more needs to be learned about why there appears to be a difference in chemo response by race, whether there may be socioeconomic factors at play, biology, or both. If it’s better understood, there is the possibility that more effective treatments may exist, that are tailored for a patients’ race or ethnicity.
Dr. DiNome says, “All of the clinical trials that led to the development of these regimes of treatment for women with triple-negative breast cancer focused primarily on white women. Minority women were historically underrepresented. A lot of this data comes from those trials so we never really had a way of assessing: 'Does this therapy work the same for all women?'”
She adds, “Our hope for future research based on the results of our study is to really understand the biological differences that may exist in these cancer subtypes so that we can actually find more effective therapies for women who have this aggressive cancer.”
The research is among the latest to highlight the disparities Black women face when diagnosed with breast cancer. Black women are more apt to die of the disease, regardless of which form they have, particularly if they’re under 50. Possible contributing factors include inadequate health insurance or health care facility access, along with biology.
