Early Chemotherapy Less Likely to Benefit African American Women

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Chemosensitivity, treatment variations, and socioeconomic factors may be a significant factor.

Among minorities treated for breast cancer with early chemotherapy, African American women were found to be less likely to benefit from treatment in a recent study.

Prior research has shown African American, Hispanic, and Asian women are more likely to develop advanced-stage breast cancer than white women, the study noted. Minorities are subsequently more likely to receive neoadjuvant chemotherapy in order to improve overall survival.

The current study, performed by Yale Cancer Center and published in the Journal of Clinical Oncology, showed African American women have worse outcomes than other ethnic groups, however.

Investigators analyzed the National Cancer Database to evaluate racial disparities associated with neoadjuvant chemotherapy in 27,300 women with cancer in stages 1 to 3.

"Even when we controlled for the fact that minority women often present with more advanced-stage, higher-grade tumors, and more aggressive types of breast cancer overall, our team was surprised to find that black women did not respond as well to neoadjuvant chemotherapy compared to other racial groups," said first author Brigid Killelea, associate professor of surgery at the Yale School of Medicine.

Investigators believe biologic disparities in chemosensitivity, treatment variations, or socioeconomic factors unable to be adjusted for in the study may play a role in the findings.

"The next step should be to determine which drugs black women respond to and which they don't. For future studies, it will be important to have enough black women in the trials, so that we can be certain they benefit equally from new drugs as they are developed," said Donald Lannin, MD, professor of surgery at the Yale School of Medicine.

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