在乳腺癌新辅助化疗后病理完整反应和生存的种族差异
Alvaro Alvarez Soto1, Wenqi Gan2, Susan Tannenbaum1
1Carole and Ray Neag Comprehensive Cancer Center, UConn Health, Farmington, Connecticut.
概括
与白人女性相比,患有乳腺癌的黑人女性在接受新辅助化疗后获得病理完整反应 (pCR) 的几率较低. 没有pCR的黑人女性面临着更糟糕的生存结果,突出了乳腺癌护理中的种族差异.
科学领域:
- 在瘤学瘤学.
- 健康差异 在健康上的差异
- 流行病学 流行病学
背景情况:
- 病理完整反应 (pCR) 是乳腺癌治疗疗效的关键代用终点,特别是在高风险病例中.
- 现有的关于pCR种族差异的研究在不同的数据来源和环境中产生了不同的结果.
- 监测,流行病学和最终结果 (SEER) 计划提供了一个强大的数据集,用于对乳腺癌结果的人口层面分析.
研究的目的:
- 研究非转移性乳腺癌接受新辅助化疗的黑人和白人女性之间的pCR率的种族差异.
- 评估种族和pCR状态对乳腺癌特异性和全因死亡率的影响.
- 通过使用现实世界的数据,识别乳腺癌治疗结果的潜在差异.
主要方法:
- 使用SEER数据库进行了基于人口的队列研究.
- 纳入标准包括被诊断为非转移性乳腺癌的黑人和白人妇女,她们在2010年至2018年期间接受了新辅助化疗.
- 统计分析评估了pCR率和生存结果的差异,并根据相关因素进行了调整.
主要成果:
- 对10,254名患者的分析显示,与白人女性相比,黑人女性pCR的几率较低 (调整后OR,0.85;95%CI,0.76-0.95).
- 经过平均5.2年的随访后,在实现pCR的患者中,在种族之间没有观察到死亡风险的显著差异.
- 在没有达到pCR的患者中,黑人女性表现出更高的乳腺癌相关和全因死亡风险.
结论:
- 现实数据表明,黑人女性在没有达到pCR的情况下,获得pCR的可能性降低,生存结果更差.
- 这项研究强调了在临床试验环境之外的乳腺癌结局中存在显著的种族劣势.
- 这些发现强调,迫切需要有针对性的干预措施,以确保所有乳腺癌患者得到公平的治疗并改善生存率.
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