Racial differences in acute toxicities of neoadjuvant or adjuvant chemotherapy in patients with early-stage breast cancer

Hyo Sook Han, Isildinha Reis, Wei Zhao, Katsumasa Kuroi, Masakazu Toi, Eiji Suzuki, Rachel Syme, Louis Chow, Adrian Y S Yip, Stefan Glück

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Background: Racial disparities in breast cancer outcomes are attributed to differences in baseline tumour characteristics and biology, stage, age, ethnic background and socioeconomic factors. However, little is known about racial differences in treatment-related toxicities. We hypothesised that racial/ethnic differences result in differential tolerance to chemotherapy potentially, leading to compromised dose intensity/density of chemotherapy in patients with early-stage breast cancer. Methods: Data were collected from patients treated at five international centers for early breast cancer with the same adjuvant/neoadjuvant chemotherapy (FEC 100: fluorouracil 500 mg/m 2, epirubicin 100 mg/m 2, and cyclophosphamide 500 mg/m 2,every 21 d for 3-6 cycles). Toxicities were assessed by first episode of ≥grade 2 toxicity. Results: Toxicities were compared according to four race/ethnicity groups (103 Caucasian, 30 African American, 164 Asian, and 34 Hispanic patients). Tumour characteristics across four race/ethnicity groups were similar. Asians had a significantly higher rate of grade 3 haematologic toxicity than Caucasians, African Americans or Hispanic women (32%, 16%, 10%, and 15%, respectively; p < 0.05). In multivariate analysis, only lower BMI was associated with a higher incidence of ≥grade 3 toxicities. However, no significant differences in chemotherapy dose intensity/density were shown across the four race/ethnicity groups. Conclusion: Racial differences in acute toxicity were noted in women with breast cancer who were treated with FEC 100 chemotherapy, suggesting that extrapolating toxicities from chemotherapy across ethnicities is not possible and emphasising the need to validate safety of chemotherapeutic regimens in patients of different ethnicities by enhancing the participation of minorities in clinical trials.

Original languageEnglish
Pages (from-to)2537-2545
Number of pages9
JournalEuropean Journal of Cancer
Volume47
Issue number17
DOIs
StatePublished - Nov 1 2011

Fingerprint

Adjuvant Chemotherapy
Breast Neoplasms
Drug Therapy
Hispanic Americans
African Americans
Epirubicin
Fluorouracil
Cyclophosphamide
Neoplasms
Multivariate Analysis
Clinical Trials
Safety
Incidence
Therapeutics

Keywords

  • Breast cancer
  • Chemotherapy
  • Racial/ethnic difference
  • Toxicity

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Racial differences in acute toxicities of neoadjuvant or adjuvant chemotherapy in patients with early-stage breast cancer. / Han, Hyo Sook; Reis, Isildinha; Zhao, Wei; Kuroi, Katsumasa; Toi, Masakazu; Suzuki, Eiji; Syme, Rachel; Chow, Louis; Yip, Adrian Y S; Glück, Stefan.

In: European Journal of Cancer, Vol. 47, No. 17, 01.11.2011, p. 2537-2545.

Research output: Contribution to journalArticle

Han, Hyo Sook ; Reis, Isildinha ; Zhao, Wei ; Kuroi, Katsumasa ; Toi, Masakazu ; Suzuki, Eiji ; Syme, Rachel ; Chow, Louis ; Yip, Adrian Y S ; Glück, Stefan. / Racial differences in acute toxicities of neoadjuvant or adjuvant chemotherapy in patients with early-stage breast cancer. In: European Journal of Cancer. 2011 ; Vol. 47, No. 17. pp. 2537-2545.
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abstract = "Background: Racial disparities in breast cancer outcomes are attributed to differences in baseline tumour characteristics and biology, stage, age, ethnic background and socioeconomic factors. However, little is known about racial differences in treatment-related toxicities. We hypothesised that racial/ethnic differences result in differential tolerance to chemotherapy potentially, leading to compromised dose intensity/density of chemotherapy in patients with early-stage breast cancer. Methods: Data were collected from patients treated at five international centers for early breast cancer with the same adjuvant/neoadjuvant chemotherapy (FEC 100: fluorouracil 500 mg/m 2, epirubicin 100 mg/m 2, and cyclophosphamide 500 mg/m 2,every 21 d for 3-6 cycles). Toxicities were assessed by first episode of ≥grade 2 toxicity. Results: Toxicities were compared according to four race/ethnicity groups (103 Caucasian, 30 African American, 164 Asian, and 34 Hispanic patients). Tumour characteristics across four race/ethnicity groups were similar. Asians had a significantly higher rate of grade 3 haematologic toxicity than Caucasians, African Americans or Hispanic women (32{\%}, 16{\%}, 10{\%}, and 15{\%}, respectively; p < 0.05). In multivariate analysis, only lower BMI was associated with a higher incidence of ≥grade 3 toxicities. However, no significant differences in chemotherapy dose intensity/density were shown across the four race/ethnicity groups. Conclusion: Racial differences in acute toxicity were noted in women with breast cancer who were treated with FEC 100 chemotherapy, suggesting that extrapolating toxicities from chemotherapy across ethnicities is not possible and emphasising the need to validate safety of chemotherapeutic regimens in patients of different ethnicities by enhancing the participation of minorities in clinical trials.",
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AU - Han, Hyo Sook

AU - Reis, Isildinha

AU - Zhao, Wei

AU - Kuroi, Katsumasa

AU - Toi, Masakazu

AU - Suzuki, Eiji

AU - Syme, Rachel

AU - Chow, Louis

AU - Yip, Adrian Y S

AU - Glück, Stefan

PY - 2011/11/1

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N2 - Background: Racial disparities in breast cancer outcomes are attributed to differences in baseline tumour characteristics and biology, stage, age, ethnic background and socioeconomic factors. However, little is known about racial differences in treatment-related toxicities. We hypothesised that racial/ethnic differences result in differential tolerance to chemotherapy potentially, leading to compromised dose intensity/density of chemotherapy in patients with early-stage breast cancer. Methods: Data were collected from patients treated at five international centers for early breast cancer with the same adjuvant/neoadjuvant chemotherapy (FEC 100: fluorouracil 500 mg/m 2, epirubicin 100 mg/m 2, and cyclophosphamide 500 mg/m 2,every 21 d for 3-6 cycles). Toxicities were assessed by first episode of ≥grade 2 toxicity. Results: Toxicities were compared according to four race/ethnicity groups (103 Caucasian, 30 African American, 164 Asian, and 34 Hispanic patients). Tumour characteristics across four race/ethnicity groups were similar. Asians had a significantly higher rate of grade 3 haematologic toxicity than Caucasians, African Americans or Hispanic women (32%, 16%, 10%, and 15%, respectively; p < 0.05). In multivariate analysis, only lower BMI was associated with a higher incidence of ≥grade 3 toxicities. However, no significant differences in chemotherapy dose intensity/density were shown across the four race/ethnicity groups. Conclusion: Racial differences in acute toxicity were noted in women with breast cancer who were treated with FEC 100 chemotherapy, suggesting that extrapolating toxicities from chemotherapy across ethnicities is not possible and emphasising the need to validate safety of chemotherapeutic regimens in patients of different ethnicities by enhancing the participation of minorities in clinical trials.

AB - Background: Racial disparities in breast cancer outcomes are attributed to differences in baseline tumour characteristics and biology, stage, age, ethnic background and socioeconomic factors. However, little is known about racial differences in treatment-related toxicities. We hypothesised that racial/ethnic differences result in differential tolerance to chemotherapy potentially, leading to compromised dose intensity/density of chemotherapy in patients with early-stage breast cancer. Methods: Data were collected from patients treated at five international centers for early breast cancer with the same adjuvant/neoadjuvant chemotherapy (FEC 100: fluorouracil 500 mg/m 2, epirubicin 100 mg/m 2, and cyclophosphamide 500 mg/m 2,every 21 d for 3-6 cycles). Toxicities were assessed by first episode of ≥grade 2 toxicity. Results: Toxicities were compared according to four race/ethnicity groups (103 Caucasian, 30 African American, 164 Asian, and 34 Hispanic patients). Tumour characteristics across four race/ethnicity groups were similar. Asians had a significantly higher rate of grade 3 haematologic toxicity than Caucasians, African Americans or Hispanic women (32%, 16%, 10%, and 15%, respectively; p < 0.05). In multivariate analysis, only lower BMI was associated with a higher incidence of ≥grade 3 toxicities. However, no significant differences in chemotherapy dose intensity/density were shown across the four race/ethnicity groups. Conclusion: Racial differences in acute toxicity were noted in women with breast cancer who were treated with FEC 100 chemotherapy, suggesting that extrapolating toxicities from chemotherapy across ethnicities is not possible and emphasising the need to validate safety of chemotherapeutic regimens in patients of different ethnicities by enhancing the participation of minorities in clinical trials.

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KW - Chemotherapy

KW - Racial/ethnic difference

KW - Toxicity

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