Racial variation in adjuvant chemotherapy initiation among breast cancer patients receiving oncotype DX testing

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• 作者：Megan C. Roberts ; Morris Weinberger…
• 关键词：Oncology ; Breast cancer ; Cancer ; Disparities ; Gene expression profiling
• 刊名：Breast Cancer Research and Treatment
• 出版年：2015
• 出版时间：August 2015
• 年：2015
• 卷：153
• 期：1
• 页码：191-200
• 全文大小：431 KB
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• 作者单位：Megan C. Roberts (1) (2)
  Morris Weinberger (1) (3)
  Stacie B. Dusetzina (1) (2) (4)
  Michaela A. Dinan (5) (6)
  Katherine E. Reeder-Hayes (2) (7)
  Melissa A. Troester (2) (8)
  Lisa A. Carey (7)
  Stephanie B. Wheeler (1) (2)
  
  1. Health Policy Management, Gillings School of Global Public Health, University of North Carolina, 135 Dauer Drive, McGavran Greenberg Hall, CB #7411, Chapel Hill, NC, 27599-7411, USA
  2. Lineberger Comprehensive Cancer Center, UNC, 1103C McGavran-Greenberg, CB# 7411, Chapel Hill, NC, 27599-7411, USA
  3. Center for Health Services Research, Durham Veterans Affairs Medical Center, 1105b McGavran-Greeberg Hall, CB# 7411, Chapel Hill, NC, 27599-7411, USA
  4. Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, UNC, 2203 Kerr Hall, CB# 7573, Chapel Hill, NC, 27599, USA
  5. Duke Clinical Research Institute, Duke University, 2400 Pratt Street, Durham, NC, 27705, USA
  6. Duke Cancer Institute, Duke University, 2400 Pratt Street, Durham, NC, 27705, USA
  7. Department of Medicine, School of Medicine, UNC, 170 Manning Drive, CB# 7305, Chapel Hill, NC, 27599, USA
  8. Epidemiology, Gillings School of Global Public Health, UNC, 2104H McGavran-Greenberg, CB# 7435, Chapel Hill, NC, 27599-7435, USA
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Oncology
  
• 出版者：Springer Netherlands
• ISSN：1573-7217

文摘

It is unknown whether racial differences exist in adjuvant chemotherapy initiation among women with similar oncotype DX (ODX) risk scores. We examined whether adjuvant chemotherapy initiation varied by race. Data come from the Phase III, Carolina Breast Cancer Study, a longitudinal, population-based study of North Carolina women diagnosed with breast cancer between 2008 and 2014. We used modified Poisson regression and report adjusted relative risk (aRR) and 95?% confidence intervals (95?%CI) to estimate the association between race and adjuvant chemotherapy initiation across ODX risk groups among women who received the test (n?=?541). Among women who underwent ODX testing, 54.2, 37.5, and 8.3?% of women had tumors classified as low-, intermediate-, and high-risk groups, respectively. We observed no racial variation in adjuvant chemotherapy initiation. Increasing ODX risk score (aRR?=?1.39, 95?%CI?=?1.22, 1.58) and being married (aRR?=?2.92, 95?%CI?=?1.12, 7.60) were independently associated with an increased likelihood of adjuvant chemotherapy in the low-risk group. Among women in the intermediate-risk group, ODX risk score (aRR?=?1.15, 95?%CI?=?1.11, 1.20), younger age (aRR?=?1.95, 95?%CI?=?1.35, 2.81), larger tumor size (aRR?=?1.70, 95?%CI?=?1.22, 2.35), and higher income were independently associated with increased likelihood of adjuvant chemotherapy initiation. No racial differences were found in adjuvant chemotherapy initiation among women receiving ODX testing. As treatment decision-making becomes increasingly targeted with the use of genetic technologies, these results provide evidence that test results may drive treatment in a similar way across racial subgroups.