Abstract
Background
Black women are 40% more likely to die of breast cancer compared to White women. Inadequate
representation of Black patients in clinical trials may contribute to health care
inequity. We aimed to assess breast cancer clinical outcomes in Non-Hispanic Black
(Black) versus Non-Hispanic White (White) women with metastatic breast cancer (MBC)
enrolled on investigator-initiated clinical trials at Winship Cancer Institute at
Emory University, given the significant number of patients from underrepresented minority
groups seen at Winship.
Materials and Methods
Black and White women with MBC on investigator-initiated trials at Emory between 2009
and 2019 were retrospectively evaluated. Univariate analyses and multiple logistic
regression models were used to assess clinical response and treatment toxicities.
Differences in overall survival between groups was assessed using quantile analysis.
Results
Sixty-two women with MBC were included (66% White vs. 34% Black). Black patients had
less clinical benefit from the trial therapy as only 57% had partial response or stable
disease as best response compared to 78% of White women (P = .09). Quantile analysis showed significant difference in mean survival between
Whites and Blacks by the end of follow up (64 vs. 38 months). There were no significant
differences in toxicities between groups.
Conclusion
Participation rates of Black women with MBC on investigator-initiated clinical trials
at an urban cancer center were higher compared to key national trials. Black women
had worse treatment response and survival. These results reinforce the need for assessment
of tumor differences by ancestry and continued improvement in minority representation
on clinical trials.
Keywords
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Article info
Publication history
Published online: October 13, 2022
Accepted:
October 9,
2022
Received in revised form:
September 22,
2022
Received:
May 5,
2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
