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National trends in neoadjuvant chemotherapy utilization in patients with early-stage node-negative triple-negative breast cancer: the impact of the CREATE-X trial.
Rogers, Christine; Cobb, Adrienne N; Lloren, Jan I C; Chaudhary, Lubna N; Johnson, Morgan K; Huang, Chiang-Ching; Teshome, Mediget; Kong, Amanda L; Singh, Puneet; Cortina, Chandler S.
Afiliação
  • Rogers C; Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI, 53226, USA.
  • Cobb AN; Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI, 53226, USA.
  • Lloren JIC; Zibler School of Public Health, University of Wisconsin at Milwaukee, Milwaukee, WI, USA.
  • Chaudhary LN; Division of Hematology and Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
  • Johnson MK; Medical College of Wisconsin Cancer Center, Milwaukee, WI, USA.
  • Huang CC; Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI, 53226, USA.
  • Teshome M; Zibler School of Public Health, University of Wisconsin at Milwaukee, Milwaukee, WI, USA.
  • Kong AL; University of Texas MD Anderson Cancer Center, Houston, TX, USA.
  • Singh P; Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI, 53226, USA.
  • Cortina CS; Medical College of Wisconsin Cancer Center, Milwaukee, WI, USA.
Breast Cancer Res Treat ; 203(2): 317-328, 2024 Jan.
Article em En | MEDLINE | ID: mdl-37864105
PURPOSE: Neoadjuvant chemotherapy (NAC) for triple-negative breast cancer (TNBC) allows for assessment of tumor pathological response and has survival implications. In 2017, the CREATE-X trial demonstrated survival benefit with adjuvant capecitabine in patients TNBC and residual disease after NAC. We aimed to assess national rates of NAC for cT1-2N0M0 TNBC before and after CREATE-X and examine factors associated with receiving NAC vs adjuvant chemotherapy (AC). METHODS: A retrospective cohort study of women with cT1-2N0M0 TNBC diagnosed from 2014 to 2019 in the National Cancer Database (NCDB) was performed. Variables were analyzed via ANOVA, Chi-squared, Fisher Exact tests, and a multivariate linear regression model was created. RESULTS: 55,633 women were included: 26.9% received NAC, 52.4% AC, and 20.7% received no chemotherapy (median ages 53, 59, and 71 years, p < 0.01). NAC utilization significantly increased over time: 19.5% in 2014-15 (n = 3,465 of 17,777), 27.1% in 2016-17 (n = 5,140 of 18,985), and 33.6% in 2018-19 (n = 6,337 of 18,871, p < 0.001). On multivariate analysis, increased NAC was associated with younger age (< 50), non-Hispanic white race/ethnicity, lack of comorbidities, cT2 tumors, care at an academic or integrated-network cancer program, and diagnosis post-2017 (p < 0.05 for all). Patients with government-provided insurance were less likely to receive NAC (p < 0.01). Women who traveled > 60 miles for treatment were more likely to receive NAC (p < 0.01). CONCLUSION: From 2014 to 2019, NAC utilization increased for patients with cT1-2N0M0 TNBC. Racial, socioeconomic, and access disparities were observed in who received NAC vs AC and warrants interventions to ensure equitable care.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias da Mama / Neoplasias de Mama Triplo Negativas Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias da Mama / Neoplasias de Mama Triplo Negativas Idioma: En Ano de publicação: 2024 Tipo de documento: Article