Black women were less likely to complete chemotherapy and more likely to experience dose delays when treated for triple-negative breast cancer (TNBC), according to findings presented at the 2022 ASCO Annual Meeting.

“Black women suffer a poorer prognosis than White women with TNBC, and whether this is due to differences in treatment, disease biology, or socioeconomic variables is not fully known,” investigators said. “This study, conducted at a racially diverse academic medical center, aimed to investigate factors associated with unfavorable outcomes in [Black women] with TNBC.”

The retrospective study involved 131 patients who received neoadjuvant chemotherapy at Winship Cancer Institute from 2008 to 2017. Cox proportional hazard models were used to analyze progression-free survival and distance metastasis-free survival.

“Descriptive statistics were applied to delineate the relationship with racial disparity,” study authors noted.

Within the sample, the average age was 55 years, and 58.5% of participants were Black women. Despite similar disease staging at diagnosis and similar treatment responses, Black women were less likely than White women to complete chemotherapy (80.8% vs 98%, P=0.005). Black women were also more likely to require dose reductions or delays (42.5% vs 23.1%, P=0.024).

Coverage with Medicaid was associated with worse outcomes for both progression-free survival (HR 2.49, P=0.015) and distant metastasis-free survival (HR 2.73, P=0.018), and Black women were more likely to have Medicaid than White women (29.3% vs 13%).

Investigators suggested the association between Medicaid and inferior outcomes could exist “because patients with Medicaid insurance are also more likely to suffer from reduced access to transportation, childcare, and other infrastructure critical to maintaining a schedule for [chemotherapy].”

Black women were also more likely to have coexisting hypertension (65.8% vs 35.2%) and elevated body mass index (31.7% vs 27.5%).

“More research is needed to understand the reasons for the dose delays, dose reductions, and failures to complete [neoadjuvant chemotherapy] so that interventions can be designed to address them,” authors concluded.

Reference:
Patterson J, Meisel JL, Yi S, Liu Y, Cao Y, Li X. Impact of race on treatment outcomes in triple-negative breast cancer at an academic medical center. J Clin Oncol. 2022;40(suppl 16):abstr e12616. doi:10.1200/JCO.2022.40.16_suppl.e12616