Black women less likely to benefit from early chemotherapy

It is well documented that black, Hispanic, and Asian women typically develop advanced-stage breast cancer more often than white women. As a result, black women are more likely to receive neoadjuvant chemotherapy, or chemotherapy prior to surgery, in hopes of improving outcomes. However, a Yale Cancer Center study published recently in the Journal of Clinical Oncology found that among minority women treated with early chemotherapy, black women fare worse than the other groups.

For the study, researchers used the National Cancer Database to explore racial disparities in the use of, and response to, neoadjuvant chemotherapy in 27,300 women with stage I-III cancer, said the study’s first author Brigid Killelea, associate professor of surgery (oncology) in Yale School of Medicine.

“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,” Killelea said.

While the cause of this is not known, researchers suspect biologic differences in chemosensitivity, disparities in treatment, or socioeconomic factors that cannot be adjusted for in the study.

Dr. Donald Lannin, professor of surgery (oncology) and senior author on the study, said the findings should stimulate deeper research.

“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,” Lannin said.

Other authors involved in the study were Vicky Yang, Shiyi Wang, Brandon Hayse, Sarah Mougalian, Nina Horowitz, Anees Chagpar, and Lajos Pusztai.

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