NCDB analysis of racial/ethnic disparities in outcomes with neoadjuvant chemotherapy for triple-negative breast cancer

Analysis of the National Cancer Database (2010-2019) investigated the hypothesis that among women with stage I-III triple-negative breast cancer (TNBC) pathologic complete response (pCR) to neoadjuvant chemotherapy (NAC) and overall survival (OS) may vary by race/ethnicity. Among 40,890 women (median age 53 years; IQR 44-61) 29.8% achieved pCR (Non-Hispanic White 30.5%; Non-Hispanic Black 27%; Hispanic 32.6%; Non-Hispanic Asian 28.8%; Non-Hispanic Other 29.8%). Unadjusted OS was significantly higher for those with pCR compared with those with residual disease (5-year OS rate 91.7% versus 66.7; p<0.001) and this association persisten after adjustment for demographic and tumor factors. The effect of achieving pCR on OS did not differ by race/ethnicity (p for interaction 0.10). However, NHB patients were less likely (OR 0.89; p=0.001) and Hispanic patients were more likely (OR 1.19; p=0.001) to achieve pCR than NHW patients. After adjustment for patient and disease factors, including achievement of pCR, Hispanic (HR 0.76; p<0.001) and NHA (HR 0.64; p<0.001) race/ethnicity remained associated with OS. The authors conclude that odds of achieving pCR and OS in patients with TNBC appear to be associated with race/ethnicity.