Genentech Inc., San Francisco, CA, United States.
Gastroesophageal Center, Thomas Jefferson University Hospital, Philadelphia, PA, United States.
Front Public Health. 2022 May 24;10:859113. doi: 10.3389/fpubh.2022.859113. eCollection 2022.
Real-world data characterizing differences between African American (AA) and White women with metastatic triple-negative breast cancer (mTNBC) are limited. Using 9 years of data collected from community practices throughout the United States, we assessed racial differences in the proportion of patients with mTNBC, and their characteristics, treatment, and overall survival (OS).
This retrospective study analyzed de-identified data from 2,116 patients with mTNBC in the Flatiron Health database (January 2011 to March 2020). Characteristics and treatment patterns between AA and White patients with mTNBC were compared using descriptive statistics. OS was examined using Kaplan-Meier analysis and a multivariate Cox proportional hazards regression model.
Among patients with metastatic breast cancer, more AA patients (23%) had mTNBC than White patients (12%). This difference was particularly pronounced in patients who lived in the Northeast, were aged 45-65, had commercial insurance, and had initial diagnosis at stage II. AA patients were younger and more likely to have Medicaid. Clinical characteristics and first-line treatments were similar between AA and White patients. Unadjusted median OS (months) was shorter in AA (10.3; 95% confidence interval [CI]: 9.1, 11.7) vs. White patients (11.9; 95% CI: 10.9, 12.8) but not significantly different. After adjusting for potential confounders, the hazard ratio for OS was 1.09 (95% CI: 0.95, 1.25) for AA vs. White patients.
The proportion of patients with mTNBC was higher in AA than White mBC patients treated in community practices. Race did not show an association with OS. Both AA and White patients with mTNBC received similar treatments. OS was similarly poor in both groups, particularly in patients who had not received any documented anti-cancer treatment. Effective treatment remains a substantial unmet need for all patients with mTNBC.
关于转移性三阴性乳腺癌（mTNBC）患者中，非裔美国（AA）人和白人之间差异的真实世界数据较为有限。本研究利用来自美国各地社区实践的 9 年数据，评估了 mTNBC 患者中种族差异，以及他们的特征、治疗和总生存（OS）。
本回顾性研究分析了 Flatiron Health 数据库中 2116 例 mTNBC 患者的匿名数据（2011 年 1 月至 2020 年 3 月）。使用描述性统计比较 AA 和白人 mTNBC 患者之间的特征和治疗模式。使用 Kaplan-Meier 分析和多变量 Cox 比例风险回归模型来检查 OS。
在转移性乳腺癌患者中，更多的 AA 患者（23%）患有 mTNBC，而非白人患者（12%）。这种差异在居住在东北部、年龄在 45-65 岁、有商业保险且初始诊断为 II 期的患者中尤为明显。AA 患者更年轻，更可能拥有医疗补助。AA 和白人患者的临床特征和一线治疗相似。未调整的中位 OS（月）在 AA 患者中较短（10.3；95%置信区间 [CI]：9.1，11.7），而在白人患者中则较长（11.9；95% CI：10.9，12.8），但无统计学差异。调整潜在混杂因素后，AA 患者的 OS 风险比为 1.09（95% CI：0.95，1.25）。
在社区实践中治疗的 mTNBC 患者中，AA 患者的比例高于白人 mBC 患者。种族与 OS 无关联。mTNBC 患者中 AA 和白人患者接受的治疗相似。两组患者的 OS 同样较差，尤其是未接受任何有记录的抗癌治疗的患者。所有 mTNBC 患者仍然存在有效治疗的巨大未满足需求。
