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<p>We examined neoadjuvant chemotherapy (NACT) use, pathological complete response (pCR) and the association with overall survival (OS) among patients with early-stage HER2-positive breast cancer (BC). Patients ≥18 years with stage I-III HER2-positive BC from 2010–2022 who had surgery and chemotherapy were identified. Of 195,023 patients treated with chemotherapy, 37.7% received NACT. NACT use increased from 18.6% in 2010 to 63.4% in 2022 (<i>p</i> &lt; 0.001) and pCR rates rose from 21% to 47.6% (<i>p</i> &lt; 0.001). Black patients were less likely to receive NACT (aOR = 0.96;95%CI 0.93–0.99) or achieve pCR (aOR = 0.86;95%CI 0.82–0.90) than White patients. pCR was associated with a reduction in the risk of death (aHR = 0.45;95%CI 0.42–0.48). 3-year OS increased from 91% in 2010 to 95% in 2019 for patients without a pCR (<i>p</i> &lt; 0.001), and from 97% to 99% for patients with pCR (<i>p</i> = 0.002). Further research is needed to understand and address racial and ethnic disparities in treatment access and outcomes.</p>

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Racial and ethnic disparities in neoadjuvant chemotherapy patterns and outcomes in early-stage HER2-positive breast cancer

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月5日

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  • Inimfon Jackson,
  • Xiudong Lei,
  • Hui Zhao,
  • Rashmi Murthy,
  • Sharon H. Giordano,
  • Mariana Chavez-MacGregor

摘要

We examined neoadjuvant chemotherapy (NACT) use, pathological complete response (pCR) and the association with overall survival (OS) among patients with early-stage HER2-positive breast cancer (BC). Patients ≥18 years with stage I-III HER2-positive BC from 2010–2022 who had surgery and chemotherapy were identified. Of 195,023 patients treated with chemotherapy, 37.7% received NACT. NACT use increased from 18.6% in 2010 to 63.4% in 2022 (p < 0.001) and pCR rates rose from 21% to 47.6% (p < 0.001). Black patients were less likely to receive NACT (aOR = 0.96;95%CI 0.93–0.99) or achieve pCR (aOR = 0.86;95%CI 0.82–0.90) than White patients. pCR was associated with a reduction in the risk of death (aHR = 0.45;95%CI 0.42–0.48). 3-year OS increased from 91% in 2010 to 95% in 2019 for patients without a pCR (p < 0.001), and from 97% to 99% for patients with pCR (p = 0.002). Further research is needed to understand and address racial and ethnic disparities in treatment access and outcomes.