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SABCS 2022 | Racial disparities in breast cancer and metastasis and possible contributing biological factors

Joseph Sparano, MD, Icahn School of Medicine at Mount Sinai, New York, NY, discusses racial disparities in cancer care. Although breast cancer mortality rates have declined, there continues to be disparities in Black compared to White woman, much of which is attributed to lack of access to care, insurance status and other social determinants of health. When evaluating outcomes in the Phase III TAILORx (NCT00310180) trial, which included woman with ER-positive, lymph-node negative breast cancer who had the 21-gene Oncotype DX Recurrence Score to guide adjuvant chemotherapy, despite Black woman having comparable clinical presentation, recurrence score and treatment, Black woman were shown to have worse outcomes. Racial disparities were also revealed in the Phase III RxPONDER (NCT01272037) trial in patients with invasive breast cancer, whereby the likelihood of having a distant recurrence was up to 70% higher in Black woman compared with White woman. A novel biomarker called tumor microenvironment of metastasis doorways (TMEM) was explored, that has been shown to correlate with a higher risk of metastasis. The investigators found that Black woman had higher TMEM density scores compared to White woman, which could be contributing to the higher recurrence risk in Black woman. Understanding this potential mechanism driving metastasis opens up the potential for the development of specific therapeutics that could prevent the development of metastasis. This interview took place at the San Antonio Breast Cancer Symposium (SABCS) 2022 in San Antonio, TX.

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