J Breast Cancer.  2024 Feb;27(1):54-60. 10.4048/jbc.2023.0166.

Racial/Ethnic Differences in Pathologic Complete Response to Neoadjuvant Chemotherapy and Survival Among Early-Stage, Erb-B2 Receptor Tyrosine Kinase 2-Low Breast Cancer Patients

• Freeman JQ
• Li JL
• Omoleye OJ

• KMID: 2553577
• DOI: http://doi.org/10.4048/jbc.2023.0166

Abstract

Racial/ethnic differences in pathologic complete response (pCR), and in overall survival (OS) by pCR status, among early-stage, erb-b2 receptor tyrosine kinase 2 (ERBB2)-low breast cancer patients after neoadjuvant chemotherapy (NACT) are unknown. Data were from the 2010–2020 National Cancer Database that included Asian/Pacific Islander (API), American Indian/Alaska Native/Other (AIANO), Black, Hispanic, and White patients. pCR and OS were modeled using logistic regression and Cox regression, respectively. Of 25,577 patients, Black patients achieved a 17.4% pCR rate, Hispanic 16.0%, White 14.7%, API 13.5%, and AIANO 10.9%. AIANO patients had lower odds of pCR than White patients (adjusted odds ratio, 0.66; 95% confidence interval [CI], 0.48–0.91). Among patients without pCR, API (adjusted hazard ratio [aHR], 0.62; 95% CI, 0.51–0.76) and Hispanic (aHR, 0.77; 95% CI, 0.67–0.89) patients had lower mortality risks than White patients. Among patients with pCR, similar OS rates were observed between Hispanic (aHR, 1.08; 95% CI, 0.66–1.78), Black (aHR, 0.77; 95% CI, 0.55–1.09), API (aHR, 0.41; 95% CI, 0.15–1.12), or AIANO (aHR, 0.35; 95% CI, 0.05–2.50) and White patients. Post-NACT pCR rates were similar across racial/ethnic groups of early-stage, ERBB2-low breast cancer patients. Among patients without pCR, API and Hispanic patients had better OS; among patients with pCR, there was no differential OS by race/ethnicity. Our findings suggest the need for longitudinal studies of OS differences in this patient population.

Keyword

Breast Neoplasms; Ethnic and Racial Minorities; Neoadjuvant Therapy; Receptor, ErbB-2; Survival Rate