TY - JOUR
T1 - Pathologic complete response in breast cancer patients receiving anthracycline- and taxane-based neoadjuvant chemotherapy
T2 - Evaluating the effect of race/ethnicity
AU - Chavez-MacGregor, Mariana
AU - Litton, Jennifer
AU - Chen, Huiqin
AU - Giordano, Sharon H.
AU - Hudis, Clifford A.
AU - Wolff, Antonio C.
AU - Valero, Vicente
AU - Hortobagyi, Gabriel N.
AU - Bondy, Melissa L.
AU - Gonzalez-Angulo, Ana Maria
PY - 2010/9/1
Y1 - 2010/9/1
N2 - BACKGROUND: The current study was conducted to evaluate the influence of race/ethnicity and tumor subtype in pathologic complete response (pCR) following treatment with neoadjuvant chemotherapy. METHODS: A total of 2074 patients diagnosed with breast cancer between 1994 and 2008 who were treated with neoadjuvant anthracycline-and taxane-based chemotherapy were included. pCR was defined as no residual invasive cancer in the breast and axilla. The Kaplan-Meier product-limit was used to calculate survival outcomes. Cox proportional hazards models were fitted to determine the relationship of patient and tumor variables with outcome. RESULTS: The median patient age was 50 years; 14.6% of patients were black, were 15.2% Hispanic, 64.3% were white, and 5.9% were of other race. There were no differences in pCR rates among race/ethnicity (12.3% in black, 14.2% in Hispanics, 12.3% in whites, and 11.5% in others, P = .788). Lack of pCR, breast cancer subtype, grade 3 tumors, and lymphovascular invasion were associated with worse recurrence-free survival (RFS) and overall survival (OS) (P ≤ .0001). Differences in RFS by race/ethnicity were noted in the patients with hormone receptor-positive disease (P = .007). On multivariate analysis, Hispanics had improved RFS (hazard ratio [HR], 0.69; 95% confidence interval [95% CI], 0.49-0.97) and OS (HR, 0.63; 95% CI, 0.41-0.97); blacks had a trend toward worse outcomes (RFS: HR, 1.28 [95% CI, 0.97-1.68] and OS: HR, 1.32 [95% CI, 0.97-1.81]) when compared with whites. CONCLUSIONS: In this cohort of patients, race/ethnicity was not found to be significantly associated with pCR rates. On a multivariate analysis, improved outcomes were observed in Hispanics and a trend toward worse outcomes in black patients, when compared with white patients. Further research was needed to explore the potential differences in biology and outcomes.
AB - BACKGROUND: The current study was conducted to evaluate the influence of race/ethnicity and tumor subtype in pathologic complete response (pCR) following treatment with neoadjuvant chemotherapy. METHODS: A total of 2074 patients diagnosed with breast cancer between 1994 and 2008 who were treated with neoadjuvant anthracycline-and taxane-based chemotherapy were included. pCR was defined as no residual invasive cancer in the breast and axilla. The Kaplan-Meier product-limit was used to calculate survival outcomes. Cox proportional hazards models were fitted to determine the relationship of patient and tumor variables with outcome. RESULTS: The median patient age was 50 years; 14.6% of patients were black, were 15.2% Hispanic, 64.3% were white, and 5.9% were of other race. There were no differences in pCR rates among race/ethnicity (12.3% in black, 14.2% in Hispanics, 12.3% in whites, and 11.5% in others, P = .788). Lack of pCR, breast cancer subtype, grade 3 tumors, and lymphovascular invasion were associated with worse recurrence-free survival (RFS) and overall survival (OS) (P ≤ .0001). Differences in RFS by race/ethnicity were noted in the patients with hormone receptor-positive disease (P = .007). On multivariate analysis, Hispanics had improved RFS (hazard ratio [HR], 0.69; 95% confidence interval [95% CI], 0.49-0.97) and OS (HR, 0.63; 95% CI, 0.41-0.97); blacks had a trend toward worse outcomes (RFS: HR, 1.28 [95% CI, 0.97-1.68] and OS: HR, 1.32 [95% CI, 0.97-1.81]) when compared with whites. CONCLUSIONS: In this cohort of patients, race/ethnicity was not found to be significantly associated with pCR rates. On a multivariate analysis, improved outcomes were observed in Hispanics and a trend toward worse outcomes in black patients, when compared with white patients. Further research was needed to explore the potential differences in biology and outcomes.
KW - Breast cancer
KW - Neoadjuvant chemotherapy
KW - Pathologic complete response
KW - Race
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U2 - 10.1002/cncr.25296
DO - 10.1002/cncr.25296
M3 - Article
C2 - 20564153
AN - SCOPUS:77956823470
SN - 0008-543X
VL - 116
SP - 4168
EP - 4177
JO - Cancer
JF - Cancer
IS - 17
ER -