Racial Differences in Symptom Burden and Endocrine Therapy Adherence in Breast Cancer: A Post Hoc Analysis of a...

Area of Science:

• Oncology
• Health Disparities
• Clinical Trials

Background:

• Adjuvant endocrine therapy (AET) is vital for reducing breast cancer recurrence.
• Persistent racial differences in AET nonadherence suggest underlying factors like symptom burden.
• The THRIVE trial investigated symptom burden and AET adherence across racial groups.

Purpose of the Study:

• To analyze symptom burden and AET adherence by race in early-stage breast cancer patients.
• To identify factors contributing to racial disparities in AET adherence.

Main Methods:

• Post hoc analysis of the THRIVE trial (NCT03592771) including Black and White women.
• Symptom burden assessed using the FACT-ES instrument at baseline, 6, and 12 months.
• AET adherence measured via electronically monitored pillboxes; multivariable regression and Kitagawa-Oaxaca-Blinder decomposition used.

Main Results:

• Black participants (n=102) were younger with lower income/health literacy than White participants (n=192).
• Black women reported worse baseline and 12-month symptoms but similar symptom improvement.
• 1-year AET adherence was lower in Black (43.0%) versus White women (60%), with baseline symptoms and sociodemographics explaining 58% of this difference.

Conclusions:

• Black women exhibit lower 1-year AET adherence compared to White women.
• Baseline symptoms and sociodemographic characteristics significantly contribute to this adherence gap.
• Targeted symptom management and addressing social determinants of health are essential to reduce AET adherence disparities.