At the recent San Antonio Breast Cancer Symposium (SABCS), Yara Abdou, MD, Assistant Professor of Hematology and Oncology and Medical Oncologist at The University of North Carolina School of Medicine, presented her team's research on the disparities that Black women with breast cancer experience. Afterwards, she spoke with Oncology Data Advisor to go into further detail on her findings, as well as to answer a few questions regarding future clinical trials and research to explore disparities Black women and other marginalized groups experience in breast cancer treatment.
Oncology Data Advisor: Alongside the outcome disparities experienced by Black women in this study, were any societal barriers considered that could potentially cause further disparities? If not, do you plan on incorporating this into future studies?
Yara Abdou, MD: Despite analyzing a carefully chosen study population, outcome differences may remain due to health care access issues and other societal barriers, and treatment within a clinical trial can still differ across patients. In this study, we did note some differences in chemotherapy received, where pre-menopausal non-Hispanic Black women received less anthracycline chemotherapy compared to non-Hispanic White women. The reason behind this is still unknown, and we do not know whether that contributed to the outcome disparities noted.Therefore, future analysis of social determinants of health (SDOH) based on geographic location will be explored as a potential contributing factor.
Oncology Data Advisor: What can investigators do to increase clinical trial accrual of Black and other minority patients to help acquire more in-depth and mature results to measure the disparities they experience in treatment?
Dr. Abdou: There are a lot of current efforts to increase minority participation in clinical trials through the National Cancer Institute (NCI) and other large cooperative groups such as the Southwestern Oncology Group (SWOG) and Alliance groups.There are several ways to do so, such as increasing cultural awareness amongst health care professionals, examining bias, and stereotyping and the impact it has on recruitment to cancer clinical trials, lowering eligibility requirements that could discriminate against certain populations, and most importantly engaging our patient advocates and involving them in the design of our trials to help recruit and retain minority patients on clinical trials.
Oncology Data Advisor: Are there any upcoming or ongoing trials to study potential disparities in Hispanic, Asian, and Native American/Pacific Islander patient populations that your institution is working on, or that you yourself are looking forward to?
Dr. Abdou: Tumor biology may differ by race, contributing to racial and ethnic disparities in breast cancer. The University of North Carolina (UNC)–led Carolina Breast Cancer Study (CBCS), which was designed to oversample Black and young women with early-stage breast cancer, is a great resource to investigate biologic heterogeneity in minority patients with breast cancer. I will be utilizing tumors from the CBCS study to explore molecular and immune differences by race in patients with breast cancer. Results from this study will provide critical information to support initiation of novel immunotherapeutic strategies to improve clinical outcomes in Black women and reduce racial disparities in breast cancer.
Additionally, we've previously found that young Black women are less likely to initiate endocrine therapy (ET) after finishing chemotherapy, that Black women report a greater side effect burden from ET, and that they are less likely to be adherent to their ET regimen after two years of treatment.In the ongoing GETSET trial (A191901), a four-arm randomized study, led by Katie Reeder-Hayes from UNC Lineberger Comprehensive Cancer Center, we are testing remotely delivered interventions, including text message reminders and telephone counseling, to boost ET adherence, with a particular focus on the needs and concerns of Black women.
Oncology Data Advisor: Thank you so much Dr. Abdou, this is great information and it's good to know we have these research and trials to look forward to!
About Dr. Abdou
Yara Abdou, MD, is a Medical Oncologist and Assistant Professor in the Division of Oncology at The University of North Carolina School of Medicine. Her research interest and practice revolve around early-stage and metastatic breast cancer, including racial disparities, immunotherapy, immune microenvironment, and clinical trials. Dr. Abdou has served as a Journal of Clinical Oncology (JCO)-American Society of Clinical Oncology (ASCO) Editorial Fellow, and she as earned many awards including the Merit Award from the Conquer Cancer Foundation of ASCO.