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Racial disparities in treatment patterns and clinical outcomes in patients with HER2-positive metastatic breast cancer.

Rugo HS, Brufsky AM, Ulcickas Yood M, Tripathy D, Kaufman PA, Mayer M, Yoo B, Abidoye OO, Yardley DA - Breast Cancer Res. Treat. (2013)

Bottom Line: In patients treated with trastuzumab, the incidence of cardiac safety events (grade ≥3) was higher in black patients (10.9 %) than in white patients (7.9 %).Unadjusted median OS and PFS (months) were significantly lower in black patients than in white patients (OS: black: 27.1, 95 % confidence interval [CI] 21.3-32.1; white: 37.3, 95 % CI 34.6-41.1; PFS: black: 7.0, 95 % CI 5.7-8.2; white: 10.2, 95 % CI 9.3-11.2).The adjusted OS hazard ratio (HR) for black patients compared with white patients was 1.29 (95 % CI 1.00-1.65); adjusted PFS HR was 1.29 (95 % CI 1.05-1.59).

View Article: PubMed Central - PubMed

Affiliation: University of California San Francisco Helen Diller Family Comprehensive Cancer Center, 1600 Divisadero Street, Box 1710, San Francisco, CA, 94143-1710, USA, hrugo@medicine.ucsf.edu.

ABSTRACT
Data characterizing demographics, treatment patterns, and clinical outcomes in black patients with human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer (MBC) are limited. registHER is a large, observational cohort study of patients (n = 1,001) with HER2-positive MBC diagnosed ≤6 months of enrollment and followed until death, disenrollment, or June 2009 (median follow-up of 27 months). Demographics, treatment patterns, and clinical outcomes were described for black (n = 126) and white patients (n = 793). Progression-free survival (PFS) following first-line therapy and overall survival (OS) were examined. Multivariate analyses adjusted for baseline and treatment factors. Black patients were more likely than white patients to be obese (body mass index ≥30), to have diabetes, and to have a history of cardiovascular disease; they were also less likely to have estrogen receptor or progesterone receptor positive disease. In patients treated with trastuzumab, the incidence of cardiac safety events (grade ≥3) was higher in black patients (10.9 %) than in white patients (7.9 %). Unadjusted median OS and PFS (months) were significantly lower in black patients than in white patients (OS: black: 27.1, 95 % confidence interval [CI] 21.3-32.1; white: 37.3, 95 % CI 34.6-41.1; PFS: black: 7.0, 95 % CI 5.7-8.2; white: 10.2, 95 % CI 9.3-11.2). The adjusted OS hazard ratio (HR) for black patients compared with white patients was 1.29 (95 % CI 1.00-1.65); adjusted PFS HR was 1.29 (95 % CI 1.05-1.59). This real-world evaluation of a large cohort of patients with HER2-positive MBC shows poorer prognostic factors and independently worse clinical outcomes in black versus white patients. Further research is needed to identify potential biologic differences that could have predictive impact for black patients or that could explain these differences.

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Related in: MedlinePlus

Kaplan–Meier plots showing first-line a PFS and b OS since diagnosis of metastatic breast cancer in black and white patients. CI confidence interval, HR hazard ratio, OS overall survival, PFS progression-free survival
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Fig2: Kaplan–Meier plots showing first-line a PFS and b OS since diagnosis of metastatic breast cancer in black and white patients. CI confidence interval, HR hazard ratio, OS overall survival, PFS progression-free survival

Mentions: The unadjusted median first-line PFS was substantially lower among black patients than among white patients (7.0 months [95 % CI 5.7–8.2] vs. 10.2 months [95 % CI 9.3–11.2]; Fig. 2a). Unadjusted median OS was also substantially lower among black patients than among white patients (27.1 months [95 % CI 21.3–32.1] vs. 37.3 months [95 % CI 34.6–41.1]; Fig. 2b).Fig. 2


Racial disparities in treatment patterns and clinical outcomes in patients with HER2-positive metastatic breast cancer.

Rugo HS, Brufsky AM, Ulcickas Yood M, Tripathy D, Kaufman PA, Mayer M, Yoo B, Abidoye OO, Yardley DA - Breast Cancer Res. Treat. (2013)

Kaplan–Meier plots showing first-line a PFS and b OS since diagnosis of metastatic breast cancer in black and white patients. CI confidence interval, HR hazard ratio, OS overall survival, PFS progression-free survival
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3824350&req=5

Fig2: Kaplan–Meier plots showing first-line a PFS and b OS since diagnosis of metastatic breast cancer in black and white patients. CI confidence interval, HR hazard ratio, OS overall survival, PFS progression-free survival
Mentions: The unadjusted median first-line PFS was substantially lower among black patients than among white patients (7.0 months [95 % CI 5.7–8.2] vs. 10.2 months [95 % CI 9.3–11.2]; Fig. 2a). Unadjusted median OS was also substantially lower among black patients than among white patients (27.1 months [95 % CI 21.3–32.1] vs. 37.3 months [95 % CI 34.6–41.1]; Fig. 2b).Fig. 2

Bottom Line: In patients treated with trastuzumab, the incidence of cardiac safety events (grade ≥3) was higher in black patients (10.9 %) than in white patients (7.9 %).Unadjusted median OS and PFS (months) were significantly lower in black patients than in white patients (OS: black: 27.1, 95 % confidence interval [CI] 21.3-32.1; white: 37.3, 95 % CI 34.6-41.1; PFS: black: 7.0, 95 % CI 5.7-8.2; white: 10.2, 95 % CI 9.3-11.2).The adjusted OS hazard ratio (HR) for black patients compared with white patients was 1.29 (95 % CI 1.00-1.65); adjusted PFS HR was 1.29 (95 % CI 1.05-1.59).

View Article: PubMed Central - PubMed

Affiliation: University of California San Francisco Helen Diller Family Comprehensive Cancer Center, 1600 Divisadero Street, Box 1710, San Francisco, CA, 94143-1710, USA, hrugo@medicine.ucsf.edu.

ABSTRACT
Data characterizing demographics, treatment patterns, and clinical outcomes in black patients with human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer (MBC) are limited. registHER is a large, observational cohort study of patients (n = 1,001) with HER2-positive MBC diagnosed ≤6 months of enrollment and followed until death, disenrollment, or June 2009 (median follow-up of 27 months). Demographics, treatment patterns, and clinical outcomes were described for black (n = 126) and white patients (n = 793). Progression-free survival (PFS) following first-line therapy and overall survival (OS) were examined. Multivariate analyses adjusted for baseline and treatment factors. Black patients were more likely than white patients to be obese (body mass index ≥30), to have diabetes, and to have a history of cardiovascular disease; they were also less likely to have estrogen receptor or progesterone receptor positive disease. In patients treated with trastuzumab, the incidence of cardiac safety events (grade ≥3) was higher in black patients (10.9 %) than in white patients (7.9 %). Unadjusted median OS and PFS (months) were significantly lower in black patients than in white patients (OS: black: 27.1, 95 % confidence interval [CI] 21.3-32.1; white: 37.3, 95 % CI 34.6-41.1; PFS: black: 7.0, 95 % CI 5.7-8.2; white: 10.2, 95 % CI 9.3-11.2). The adjusted OS hazard ratio (HR) for black patients compared with white patients was 1.29 (95 % CI 1.00-1.65); adjusted PFS HR was 1.29 (95 % CI 1.05-1.59). This real-world evaluation of a large cohort of patients with HER2-positive MBC shows poorer prognostic factors and independently worse clinical outcomes in black versus white patients. Further research is needed to identify potential biologic differences that could have predictive impact for black patients or that could explain these differences.

Show MeSH
Related in: MedlinePlus