According to the data presented at the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved held from September 21–24, 2024, there is evidence that the frequency of immunotherapy for Black patients with triple-negative breast cancer (TNBC) in recent years was lower than that of White patients.
TNBC affects black women most because of how aggressive it is; characterised by the absence of three cell surface receptors. The lack of these receptors means that patients diagnosed with TNBC cannot be treated with many of the given molecular targeted therapies applied in the management of other forms of breast cancer as elucidated by the study presenter Jincong Q. Freeman, MPH, Ph. D. candidate at the University of Chicago in the lab of Frederick M. Howard, MD.
“This failure, along with the observed higher intrinsic aggressiveness of TNBC and the absence of a treatment option related to the biology of the cancer, led to poorer outcomes for the patients with this disease,” Hugh expanded, mentioning his job as an assistant professor of the University of Chicago.
Specifically, immunotherapy has recently emerged as a potential treatment for mTNBC given the positive results seen in clinical trials that supported approval of pembrolizumab (Keytruda) as a first-line treatment for metastatic TNBC with PD-L1 expression in 2020, and as adjuvant therapy for high-risk early-stage TNBC in 2021.
In the immunotherapy arm, pathologic complete response and overall survival of Black and white patients with esTNBC and mTNBC were comparable. ‘How does race influence the get-access-to and survival of metastatic TNBC patients who did or did not receive immunotherapies?’ ‘A significant discovery of the present research study is that unlike the white patients, black patients with metastatic TNBC had lower rates of getting immunotherapy but the overall survival rates were almost similar,’ said Freeman.
This means that immunotherapy may help reduce the disparity in survival caused by race among metastatic TNBC patients.
Patients with TNBC who had lesser chances of receiving immunotherapy were those who are under Medicare enrolment, and those who received treatment from a comprehensive community programme, with respective percentages of 16% and 20%-21% lower than the patients who received treatment from academic or research institutions.
Because PD-L1 expression is a requirement for pembrolizumab treatment of metastatic TNBC, Howard stressed that there is a need for further studies to identify if there is a disparity in tumour PD-L1 expression between Black and white patients that may have driven the observed discordance in immunotherapy uptake.
Reference:
American. Black patients with triple-negative breast cancer may be less likely to receive immunotherapy than white patients
