Higher Incidence of Treatment Changes Confers Worse Outcomes for Black Women With Breast Cancer

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Black breast cancer patients were more likely to experience changes or discontinuation of neoadjuvant therapy than white patients.

Black breast cancer patients were more likely to experience neoadjuvant changes or interruptions than white patients, according to a study presented at the San Antonio Breast Cancer Symposium Findings 2021 (SABCS).1

According to the study authors, the higher incidence of treatment changes may lead to poorer outcomes in this patient population.

But the results of this proof-of-concept study demonstrated that using a multi-scale biophysical modeling platform can help identify what treatment outcomes may look like before clinicians and patients decide to change. current treatment.

The researchers conducted a retrospective review of 173 patients who had received neoadjuvant therapy from January 2010 to March 2020 and separated the patients into 2 cohorts: 114 who received a scheduled regimen (SR) and 59 who received a modified regimen ( MR) Although there were almost double the number of patients in the SR group than in the MR cohort, black patients made up 59% of the MR cohort.

In the MR group, a significantly lower proportion of patients achieved a pathologic complete response (pCR) compared to the SR group (odds ratio, 0.44; P = .03). In addition, similar to what has been observed in other studies, 42% of black patients suffered treatment interruptions compared to 25% of white patients.

“During neoadjuvant therapy for breast cancer, treatment interruptions may impact rates of complete pathologic response and ultimately increase the risk of recurrence,” the study authors wrote in their report. poster at SABCS.

Six patients (10%) had early discontinuation of doxorubicin and cyclophosphamide, 25 patients (42%) had early discontinuation of taxane treatment, 7 patients (12%) had discontinued anti-HER2 treatment and 21 patients (36%) had dose reductions throughout their treatment.

The study authors observed a pCR rate of 42% in the SR group and 20% in the MR group.

Using the multiscale biophysical modeling platform, known as TumorScope, the researchers were able to use data from patients in the RM group and simulate what responses to treatment might have been had the patients received the full dose of their treatment without interruption. The simulation demonstrated that without interruption of treatment, 10 additional patients (5.6%) could have achieved pCR. In the simulation, 100% of patients receiving RS had a complete response compared to 81.7% of those who would experience treatment interruptions.

TumorScope has already been evaluated in a separate study to determine its effectiveness and has been used in several other studies and analyzes presented at this year’s SABCS.2 According to the researchers of this study, the results show that TumorScope can be used to estimate the impact of varying dosage before clinicians decide to discontinue a patient’s treatment. Additionally, the researchers believe TumorScope may evaluate individual treatments being considered for this patient population to support de-escalation of treatment in advance, but note that further study is needed.

The references

  1. Pandey T, Pfeiffer J, Braun E, et al. Assessment of the impact of treatment interruptions during neoadjuvant therapy in early-stage breast cancer. Poster presented at: San Antonio Breast Cancer Symposium 2021. December 7-10, 2021. San Antonio, Texas. P1-08-21
  2. SimBioSys presents new studies on its precision medicine software platform at the 2021 San Antonio Breast Cancer Symposium. Press release. December 1, 2021. Accessed December 8, 2021. https://bwnews.pr/3oz8qAP

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