First-Line Treatment Differences Found in Black and Younger Patients with HR+/HER2– Metastatic Breast Cancer

There are disparities experienced by minority women when they are diagnosed with breast cancer which are multifactorial.¹ Tumor biology, the opportunity to enroll in clinical trials, race, genetics, and access to care are among the factors which contribute to disease burden.¹ Although great progress has been made in breast cancer management, breast cancer remains the most common cause of cancer-related death in women.¹ Overall survival rates have been rising for the past 3 decades, which have been driven by earlier disease detection and advances in targeted treatments.¹ Despite these improved outcomes they have not been experienced by all populations as racial/ethnic identity is a strong predictor of cancer mortality in breast cancer.¹ Although 16% of White American patients with breast cancer are diagnosed at <50 years of age, approximately 23% of Black American patients are diagnosed in this age subset.¹ Localized breast cancer is diagnosed in 56% of Black American patients and 66% of White American patients.¹ Black American patients are also more likely to have more aggressive cancer and higher population-based mortality rates.¹ The standard first-line treatment for patients with hormone receptor-positive, HER2-negative (HR+/HER2–) metastatic breast cancer is a CDK4/6 inhibitor + endocrine therapy which has been found to give patients better outcomes than chemotherapy.¹

A study investigated first-line treatment differences along with clinical characteristics and outcomes in Black and younger patients with HR+/HER2– metastatic breast cancer by examining 524 patients in the UNC Metastatic Breast Cancer Database. Young patients <50 years of age accounted for 30% of the study population, 20% of the patients were Black, 51% were found to have visceral involvement, and 62% had only 1 site of metastasis. Overall, 21% of patients had received chemotherapy with 29% of younger patients, 18% of older patients, 31% of Black, 18% of White, 26% of those with visceral involvement, and 16% of those with non-visceral involvement receiving chemotherapy. The progression-free survival was better for patients who received endocrine therapy either alone or with a CDK4/6 inhibitor as front-line treatment regardless of race, age, treatment group, or if there was visceral involvement.

Source:

Abdou Y, Ivory J, Deal A, et al. Treatment difference by race and age in metastatic hormone receptor-positive/HER2-negative breast cancer. Poster presented at: San Antonio Breast Cancer Symposium. December 7, 2023; San Antonio, TX. Abstract # PO4-10-04.

References:

1. Stringer-Reasor EM, Elkhanany A, Khoury K, et al. Disparities in breast cancer associated with African American identity. Am Soc Clin Oncol Educ Book. 2021;41:e29-e46.