Race and clinical outcomes in hormone receptor-positive, HER2-negative, node-positive breast cancer in the randomized RxPONDER trial

被引：2

作者：

Abdou, Yara ^{[1
]}

Barlow, William E. ^{[2
]}

Gralow, Julie R. ^{[3
]}

Meric-Bernstam, Funda ^{[4
]}

Albain, Kathy S. ^{[5
]}

Hayes, Daniel F. ^{[6
]}

Lin, Nancy U. ^{[7
]}

Perez, Edith A. ^{[8
]}

Goldstein, Lori J. ^{[9
]}

Chia, Stephen K. L. ^{[10
]}

Dhesy-Thind, Sukhbinder ^{[11
]}

Rastogi, Priya ^{[12
]}

Alba, Emilio ^{[13
]}

Delaloge, Suzette ^{[14
]}

Schott, Anne F. ^{[6
]}

Shak, Steven ^{[15
]}

Sharma, Priyanka ^{[16
]}

Lew, Danika L. ^{[2
,17
]}

Miao, Jieling ^{[2
,17
]}

Unger, Joseph M. ^{[2
,17
]}

Tripathy, Debasish ^{[4
]}

Hortobagyi, Gabriel N. ^{[4
]}

Pusztai, Lajos ^{[18
]}

Kalinsky, Kevin ^{[19
]}

机构：

[1] Univ North Carolina, Chapel Hill, NC USA

[2] SWOG Stat & Data Management Ctr, Seattle, WA USA

[3] Amer Soc Clin Oncol, Alexandria, VA USA

[4] Univ Texas MD Anderson Canc Ctr, Houston, TX USA

[5] Loyola Univ Med Ctr, Maywood, IL USA

[6] Univ Michigan, Ann Arbor, MI USA

[7] Dana Farber Canc Inst, Boston, MA USA

[8] Mayo Clin, Jacksonville, FL USA

[9] Fox Chase Canc Ctr, Philadelphia, PA USA

[10] Vancouver Canc Ctr, BCCA, Vancouver, BC, Canada

[11] McMaster Univ, Hamilton, ON, Canada

[12] Univ Pittsburgh, Sch Med, Pittsburgh, PA USA

[13] Virgen Victoria Univ Hosp Malaga, Malago, Spain

[14] Inst Gustave Roussy, Paris, France

[15] Exact Sci, Redwood City, CA USA

[16] Univ Kansas, Westwood, KS USA

[17] Fred Hutchinson Canc Ctr, Seattle, WA USA

[18] Yale Univ, New Haven, CO USA

[19] Emory Univ, Winship Canc Inst, Atlanta, GA USA

来源：

JNCI-JOURNAL OF THE NATIONAL CANCER INSTITUTE | 2025年 / 117卷 / 05期

基金：

美国国家卫生研究院;

关键词：

BODY-MASS INDEX; ENDOCRINE THERAPY ADHERENCE; RACIAL DISPARITIES; OBESITY; SURVIVAL; WOMEN; RISK; PREMENOPAUSAL; IMPACT;

D O I：

10.1093/jnci/djae314

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background The phase III RxPONDER trial has affected treatment for node-positive (1-3), hormone receptor-positive, HER2-negative breast cancer with a 21-gene recurrence score (RS) less than 26. We investigated how these findings apply to different racial and ethnic groups within the trial.Methods The trial randomly assigned women to endocrine therapy (ET) or to chemotherapy plus ET. The primary clinical outcome was invasive disease-free survival (IDFS), with distant relapse-free survival (DRFS) as a secondary outcome. Multivariable Cox models were used to evaluate the association between race/ethnicity and survival outcomes, adjusting for clinicopathological characteristics, RS, and treatment.Results A total of 4048 women with self-reported race/ethnicity were included: Hispanic (15.1%), non-Hispanic Black (NHB) (6.1%), Native American/Pacific Islander (0.8%), Asian (8.0%), and non-Hispanic White (NHW) (70%). No differences in RS distribution, tumor size, or number of positive nodes were observed by race/ethnicity. Relative to NHWs, IDFS was worse for NHB participants (5-year IDFS 91.6% vs 87.1%, HR = 1.37; 95% CI = 1.03 to 1.81) and better for Asians (91.6% vs 93.9%, HR = 0.64; 95% CI = 0.46 to 0.91). Relative to NHW, DRFS was worse for NHB participants (5-year DRFS 95.8% vs 91.0%, HR = 1.65; 95% CI = 1.17 to 2.32) and better for Asians (95.8% vs 96.7%, HR = 0.59; 95% CI = 0.37 to 0.95). Adjusting for clinical characteristics, particularly body mass index, diminished the effect of race on outcomes. Chemotherapy treatment efficacy did not differ by race/ethnicity.Conclusions NHB women had worse clinical outcomes compared with NHWs in the RxPONDER trial despite similar RS and comparable treatment. Our study emphasizes the persistent racial disparities in breast cancer outcomes while highlighting complex interactions among contributing factors.Trial Registration ClinicalTrials.gov: NCT01272037.

引用

页码：889 / 897

页数：9

共 43 条

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