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William J. Gradishar, MD, FACP, FASCO


Neoadjuvant Endocrine Therapy for Breast Cancer: Differential Responses in Black Versus White Women

By: Anna Fanelli
Posted: Wednesday, October 19, 2022

According to results presented at the 2022 American Association for Cancer Research (AACR) Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved (Abstract B122), Black women treated with neoadjuvant endocrine therapy for breast cancer were more likely to benefit than White women if treated at an earlier disease stage. However, the investigators revealed, they were still less likely to benefit than White women if treated at a later disease stage.

“This project is a critical step in unpacking the heterogeneity of hormone receptor tumor biology,” said Veronica Jones, MD, of City of Hope Medical Center, Duarte, California, and colleagues. “It brings into question how we can more effectively manage this disease to mitigate breast cancer racial disparities.”

Dr. Jones and colleagues identified a cohort of patients from the National Cancer Database (NCDB), focusing on 3,521 White women and 365 Black women with stage I–III hormone receptor–positive breast cancer who received neoadjuvant endocrine therapy.

From the study, it was found at diagnosis that Black women were 1.6 times more likely to have cancer detected in the lymph nodes and 1.5 times more likely to have stage III disease, as compared with White women. Black women also received neoadjuvant endocrine therapy longer than their White counterparts, with a median duration of 128 days and 114 days, respectively. Black women were 1.5 times more likely to receive neoadjuvant endocrine therapy for more than 24 weeks.

The investigators acknowledged some study limitations. One limitation is that percentages of estrogen and progesterone receptor positivity, which may correlate with response to endocrine therapy, were unavailable. The NCDB also did not contain information about how well patients adhered to endocrine therapy or how clinical tumor stage was determined, which may vary based on differential access to advanced imaging techniques.

Disclosure: The study authors reported no conflicts of interest.

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