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评估高危三阴性乳腺癌患者新辅助治疗后疾病转归的种族差异及残留疾病:ECOG-ACRIN 1131临床试验的事后分析

Assessing racial disparities in disease outcomes of patients with high-risk, triple-negative breast cancer and residual disease after neoadjuvant therapy: a post-hoc analysis of the ECOG-ACRIN 1131 clinical trial.

作者信息

Lloyd Kate, Newman Lisa A, Glass Charity, Ogayo Esther R, Mayer Erica L, Chavez-MacGregor Mariana, Freedman Rachel A, King Tari A, Mittendorf Elizabeth A, Kantor Olga

机构信息

Massachusetts General Hospital, Boston, MA, USA.

NewYork-Presbyterian/Weill Cornell Medical Center, New York, NY, USA.

出版信息

Breast Cancer Res Treat. 2025 Nov;214(1):101-112. doi: 10.1007/s10549-025-07798-0. Epub 2025 Aug 4.


DOI:10.1007/s10549-025-07798-0
PMID:40759832
Abstract

PURPOSE: Although triple-negative breast cancer (TNBC) is associated with increased risk for early locoregional (LRR) and distant recurrence (DR), it is unclear if there are racial differences in clinical outcomes. This study examines patterns of recurrence and breast cancer mortality (BCM) between Black and White women with high-risk TNBC treated on the Eastern Cooperative Oncology Group-American College of Radiology Imaging Network (ECOG-ACRIN) EA1311 randomized clinical trial. METHODS: From 2015 to 2021, 415 patients with clinical stage II-III TNBC and residual disease after neoadjuvant chemotherapy (NAC) were randomized to adjuvant capecitabine or platinum chemotherapy. Overall, 363 patients with self-reported Black or White race were included in this analysis. LRR, DR, and BCM were analyzed by race using Kaplan-Meier curves for unadjusted estimates and Cox modeling for adjusted analyses. RESULTS: Racial distribution included 66 (18.2%) Black and 297 (81.8%) White patients. Disease presentation, response to chemotherapy, and treatment arm were similar by race. Two-year estimated LRR was 27.1% in Black and 17.3% in White patients (p = 0.378), and 2-year estimated DR and BCM were similar by race. Models adjusted for race, age, stage, grade, treatment arm, and locoregional therapy did not identify race as an independent predictor of LRR, DR, or BCM. CONCLUSION: Among women with residual TNBC after NAC treated on this trial, there were no significant differences in LRR, DR, or BCM between Black and White patients at 2 years of follow-up. Despite the small cohort and short-term follow-up, our results suggest that treatment on a clinical trial may mitigate disparities in disease outcomes in TNBC.

摘要

目的:尽管三阴性乳腺癌(TNBC)与早期局部区域复发(LRR)和远处复发(DR)风险增加相关,但尚不清楚临床结局是否存在种族差异。本研究在东部肿瘤协作组-美国放射学会影像网络(ECOG-ACRIN)EA1311随机临床试验中,考察了高危TNBC的黑人和白人女性的复发模式及乳腺癌死亡率(BCM)。 方法:2015年至2021年,415例临床II-III期TNBC且新辅助化疗(NAC)后有残留病灶的患者被随机分配至辅助卡培他滨或铂类化疗组。总体而言,本分析纳入了363例自我报告为黑人或白人的患者。采用Kaplan-Meier曲线进行未调整估计,通过种族分析LRR、DR和BCM,并采用Cox模型进行调整分析。 结果:种族分布包括66例(18.2%)黑人患者和297例(81.8%)白人患者。种族间疾病表现、化疗反应和治疗组相似。黑人患者2年估计LRR为27.1%,白人患者为17.3%(p = 0.378),2年估计DR和BCM在种族间相似。对种族、年龄、分期、分级、治疗组和局部区域治疗进行调整的模型未将种族识别为LRR、DR或BCM的独立预测因素。 结论:在本试验中接受NAC后残留TNBC的女性中,随访2年时黑人与白人患者在LRR、DR或BCM方面无显著差异。尽管队列规模小且随访时间短,但我们的结果表明,临床试验中的治疗可能会减轻TNBC疾病结局的差异。

相似文献

[1]
Assessing racial disparities in disease outcomes of patients with high-risk, triple-negative breast cancer and residual disease after neoadjuvant therapy: a post-hoc analysis of the ECOG-ACRIN 1131 clinical trial.

Breast Cancer Res Treat. 2025-11

[2]
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Breast Cancer Res. 2025-6-23

[3]
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[4]
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[5]
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[6]
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[7]
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[8]
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[9]
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[10]
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本文引用的文献

[1]
Screening for Breast Cancer: US Preventive Services Task Force Recommendation Statement.

JAMA. 2024-6-11

[2]
Racial/Ethnic Disparities in Pathologic Complete Response and Overall Survival in Patients With Triple-Negative Breast Cancer Treated With Neoadjuvant Chemotherapy.

J Clin Oncol. 2024-5-10

[3]
Racial and Ethnic Disparities in Locoregional Recurrence Among Patients With Hormone Receptor-Positive, Node-Negative Breast Cancer: A Post Hoc Analysis of the TAILORx Randomized Clinical Trial.

JAMA Surg. 2023-6-1

[4]
Response to Treatment, Racial and Ethnic Disparity, and Survival in Patients With Breast Cancer Undergoing Neoadjuvant Chemotherapy in the US.

JAMA Netw Open. 2023-3-1

[5]
Development and Psychometric Evaluation of Healthcare Access Measures among Women with Ovarian Cancer.

Cancers (Basel). 2022-12-19

[6]
Early breast cancer survival of black and white American women with equal diagnostic and therapeutic management.

Eur J Surg Oncol. 2023-3

[7]
Breast Cancer Statistics, 2022.

CA Cancer J Clin. 2022-11

[8]
Clinical Outcomes and Immune Markers by Race in a Phase I/II Clinical Trial of Durvalumab Concomitant with Neoadjuvant Chemotherapy in Early-Stage TNBC.

Clin Cancer Res. 2022-9-1

[9]
The Emergence of the Racial Disparity in U.S. Breast-Cancer Mortality.

N Engl J Med. 2022-6-23

[10]
Randomized Phase III Postoperative Trial of Platinum-Based Chemotherapy Versus Capecitabine in Patients With Residual Triple-Negative Breast Cancer Following Neoadjuvant Chemotherapy: ECOG-ACRIN EA1131.

J Clin Oncol. 2021-8-10

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