Race is a significant predictor of downstaging in HR+ breast cancer after adjustment for duration of NET, clinical stage
TUESDAY, Sept. 20, 2022 (HealthDay News) — The response to neoadjuvant endocrine therapy (NET) for hormone receptor-positive breast cancer (HR+BC) may vary by race, according to a study presented at the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved, held from Sept. 16 to 19 in Philadelphia.
Veronica Jones, M.D., from City of Hope in Duarte, California, and colleagues examined use of NET in Black/African American (BAA) and White women with HR+BC in the National Cancer Database. NET response was assessed by race in 3,521 White and 365 BAA women.
The researchers found overall, 0.8 and 0.9 percent of participants downstaged to pT0 or pT in situ (is) and upstaged to stage IV disease, respectively; downstaging occurred only from clinical stage I or II disease, while almost all cases of upstaging occurred from stage II disease or higher. BAA women were more likely than White women to present as node-positive or stage III (odds ratios, 1.6 and 1.5, respectively); they were also more likely to be treated with NET for more than 24 weeks (odds ratio, 1.5). On multivariate analysis, BAA women were more likely than White women to downstage to pT0/Tis. The duration of NET was longer for BAA women who downstaged to pT0/Tis than their White counterparts (median, 241.0 versus 167.5 days); on multivariate analysis adjusting for duration of NET and clinical stage, race significantly predicted downstaging (odds ratio, 2.85). BAA women were more likely than White women to upstage to stage IV, despite longer treatment with NET.
“Our findings suggest that neoadjuvant endocrine therapy alone may not be the best approach in Black women who present with more advanced tumors,” Jones said in a statement.
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