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.


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.


  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.

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