Introduction
Kelly Hirko
-
In the first section, Drs. Gabrielle Rocque, Erica Reasor, and Ammanuel Taye discuss the disparities in breast cancer among African-American and Hispanic-American women. Here, researchers illustrate how the experience of systemic racism and allostatic load, as well as differences in the distribution of breast cancer molecular subtypes and tumor genomic signatures of breast tumors, contribute to observed racial and ethnic breast cancer disparities in the USA. The authors advocate for increasing racial and ethnic diversity in clinical trials to ensure that targeted therapies do not contribute to widening breast cancer disparities.
-
Drawing largely on the findings from a prospective cohort of young-onset breast cancer in the UK, the authors Drs. Alex Daly, Ramsey Cutress, and Ellen Copson in the next section of this forum article describe observed racial differences in pathological and clinical characteristics of young-onset breast cancer (diagnosed before age 50 years) and potential determinants of delayed breast cancer presentation among racial and ethnic minority women. Furthermore, racial and ethnic differences in the treatment management in young-onset breast cancer are discussed. The authors express the importance of community-engaged research to develop appropriate and acceptable solutions to mitigate disparities.
-
Next, Drs. Dae-Wun Lee, Kyung-Hun Lee, and Professor Seock-Ah Im provide an important perspective on the impact of ethnicity on the efficacy and toxicity of cyclin-dependent kinase inhibitors in breast cancer, focusing on Asian women. Here, the authors describe the molecular differences in breast cancer between Asian and Western women and discuss the underrepresentation of Asian women in endocrine therapy trials for breast cancer.
-
In the final section of this forum, Professor Yeon Hee Park focuses the discussion on ethnic differences in BRCA mutations and the use of PARP inhibitors in hereditary breast cancer. Clinical and genomic analyses of germline BRCA mutations and somatic TP53 mutations among Korean women with breast cancer are described and implications for utilization of PARP1 inhibitors are discussed.
Competing interests
Breast cancer disparities in the USA
Introduction
Structural barriers to health equity in the USA
Allostatic load impacts breast cancer health disparities
Tumor biology contributes to survival outcomes
Conclusions
Competing interests
Ethnicity, clinicopathologic features, and outcomes of young women with breast cancer in the UK
Introduction
Incidence patterns and screening inequalities
Pathological differences between the ethnic groups
Tumor characteristic | Alla, n = 2956 | White, n = 2690 | Black, n = 118 | Asian, n = 87 | |
---|---|---|---|---|---|
Tumor diameter median | 22.0 | 22.0 | 26.00 | 26.00 | W vs. B p=0.01 |
Multifocal distribution | 29.9% | 24.64% | 38.55% | 32.69% | W vs. B p = 0.004 |
Nodal stage | |||||
N0 | 48.9% | 49.2% | 43.9% | 48.2% | p = NS |
N1 | 51.2% | 50.8% | 56.1% | 51.8% | |
Distant metastases | 2.5% | 2.4% | 5.1% | 3.5% | p = NS |
Grade | |||||
1 | 5.7% | 5.6% | 0.9% | 11.8% | W vs. B p = 0.055 W vs. A p = 0.045 B vs. A p = 0.004 |
2 | 33.8% | 34.0% | 30.0% | 28.2% | |
3 | 60.6% | 60.4% | 68.1% | 60.0% | |
Missing | 2.7% | 2.5% | 4.2% | 2.3% | |
ER positiveb | 66.1% | 66.5% | 62.4% | 57.5% | NS |
ER negative | 33.9% | 33.5% | 37.6% | 42.5% | |
Missing | 0.4% | 0.4% | 0.9% | 0.0% | |
HER2 positiveb | 28.1% | 28.3% | 20.2% | 29.7% | NS |
HER2 negative | 72.0% | 71.7% | 79.8% | 70.3% | |
Missing | 13.5% | 13.7% | 7.6% | 14.9% | |
TNTc | 19.0% | 18.6% | 26.1% | 23.2% | W vs. B = 0.043 |
Missing | 4.2% | 4.2% | 2.5% | 5.8% |
Treatment
Breast cancer survival
Conclusions
Competing interests
Acknowledgements
Impact of ethnicity on efficacy and toxicity of cyclin-dependent kinase 4/6 inhibitors in breast cancer
Dae-Won Lee, Kyung-Hun Lee, Seock-Ah Im
Trial | Line of treatment | Number of patients | Regimen | Asian population | mPFS (mo), ET+CDKi vs. ET |
---|---|---|---|---|---|
MONALEESA-2 | 1st | 668 | Letrozole ± ribociclib | 7.6% | |
MONALEESA-7 | 1st | 672 | Endocrine ± ribociclib | 29.5% | 30.4 vs. 11.0 |
MONARCH-3 | 1st | 493 | NSAI ± abemaciclib | 30.0% | |
PALOMA-2 | 1st | 666 | Letrozole ± palbociclib | 14.2% | 25.7 vs. 13.9 |
MONALEESA-3 | 1st and 2nd | 726 | Fulvestrant ± ribociclib | 8.7% | NR vs. 12.7a |
MONARCH 2 | 2nd | 669 | Fulvestrant ± abemaciclib | 32.0% | 22.8 vs. .11.6 |
PALOMA-3 | 2nd or later | 521 | Fulvestrant ± palbociclib | 21.0% | NR vs. 5.8 |