Impact of Race, Socioeconomic Status, and Clinicopathologic Features on Clinical Outcomes in Triple-Negative Breast Cancer in the ECOG-ACRIN EA1131 Trial

A higher incidence of triple-negative breast cancer (TNBC) and worse social determinants of health both contribute to racial survival disparities among Black women diagnosed with breast cancer. A post hoc analysis of the ECOG-ACRIN EA1131 study (adjuvant platinum v capecitabine in stage II-III TNBC with residual disease after neoadjuvant chemotherapy) evaluated racial disparities in disease-free survival (DFS) and overall survival (OS) among Black and White patients. Of the 415 patients enrolled in EA1131, 376 were included in this analysis (308 White [82%] and 68 Black [18%]). Common characteristics included basal-subtype TNBC (77%), grade 3 disease (71%), residual stage II disease (49%), private insurance (70%), and a BMI ≥30 (49%). There were no racial differences in grade and clinical or pathologic stage. Black patients were more likely to have basal-subtype TNBC (89% v 75%; P = .009), a BMI ≥30 (62% v 46%; P = .026), to reside within the lowest neighborhood socioeconomic index quartile (39% v 22%; P = .008), and have Medicaid (32% v 13%; P < .001) compared with White patients. Despite these differences, there were no significant differences in DFS or OS by race (hazard ratio [HR], 0.99 [95% CI, 0.62 to 1.57] and HR, 0.60 [95% CI, 0.32 to 1.12], respectively) among Black and White patients.