Unveiling Disparities: Breast Cancer Treatment and the Need for Inclusive Research

In a recent study published in the Journal of the National Comprehensive Cancer Network, Dr. Kent Hoskins, a professor of oncology at the University of Illinois Chicago, and his team shed light on potential disparities in breast cancer treatment outcomes for Black women.

The study focused on the effectiveness of the oncotype test, commonly used to guide chemotherapy recommendations for patients with estrogen receptor-positive breast cancer. Hoskins highlighted concerns that the test may not accurately reflect prognoses for Black women due to underrepresentation in the trials used to develop it and differences in tumor biology.

Analyzing data from over 70,000 women with early-stage estrogen receptor-positive tumors, researchers found that the test's cutoff point for recommending chemotherapy for Black women may need adjustment. They suspect that Black women's tumors may be less responsive to estrogen-blocking pills, leading to potentially worse outcomes without chemotherapy. This highlights the importance of inclusion and diversity in clinical trials to ensure accurate representation and equitable treatment outcomes.

To address underrepresentation in cancer clinical trials, the Lynn Sage Breast Cancer Foundation is spearheading the Chicago Breast Cancer Research Consortium. This initiative aims to improve access to trials, particularly for minority populations, by partnering with multiple healthcare institutions and providing financial support to overcome barriers like travel and childcare expenses. Dr. Rita Nanda, Dr. William Gradishar, and Dr. Ruta Rao are leading the consortium at their respective institutions, with plans to expand beyond the initial three academic centers.

Laura Sage, co-chair of the Lynn Sage Breast Cancer Foundation, sees the consortium as a potential model for broader participation in cancer research. With the goal of launching several trials by 2026, the initiative aims to gather diverse data samples to better understand and treat breast cancer. 

The emphasis on diverse data samples reflects a fundamental understanding that breast cancer, like all cancers, is not a singular disease but rather a complex spectrum of conditions with varying biological and clinical characteristics. By including individuals from different demographic backgrounds, the consortium aims to uncover nuances in treatment response, disease progression, and outcomes that may have previously gone unnoticed.