20 Sep African American Women Have More Aggressive Breast Cancer Tumor Biology
Medical Research: What is the background for this study? What are the main findings?
Response: Multiple studies have consistently shown that African American women with cancer, including breast cancer, have worse outcomes than Caucasian counterparts. While socioeconomic issues, including access to care plays an important role, the contribution of tumor biology has been less clear.
In this study, utilizing exome sequencing data, we linked the racial distribution of primary breast cancer with tumor genotypic traits, including somatic mutations, gene-expression profiles and intra-tumor heterogeneity. We observed that in addition to having a higher prevalence of triple negative breast cancer than Caucasian women (something that has been documented in the literature), African American women had a significantly higher prevalence of TP53 mutations, TNBC basal-like 1 and mesenchymal stem-like tumors, and intratumor genetic heterogeneity, and all of which suggest more aggressive tumor biology, suggesting that differences in tumor genomic profile contribute, at least partly, to the known racial disparity in survival between African Americans and Caucasians breast cancer patients.
Medical Research: What should clinicians and patients take away from your report?
Response: Our findings suggest that triple negative breast cancer, even within the basal-subtype, behaves more aggressively in African Americans and thus deserves more attention from researchers and clinicians to develop treatment regimens tailored to tumor biology. It also underscores the critical need to involve higher numbers of African American patients in precision medicine research aimed at developing novel targeted therapies for subtype of triple negative breast cancer specifically seen in African Americans.
Medical Research: What recommendations do you have for future research as a result of this study?
Response: Additional research is needed to confirm these findings and understand why African Americans have a worse tumor biology. Also, additional research is needed to develop specific therapies that target the molecular breast cancer subtypes specifically seen in African Americans and potentially reduce the racial divide in breast cancer outcomes.
Keenan, B. Moy, E. A. Mroz, K. Ross, A. Niemierko, J. W. Rocco, S. Isakoff, L. W. Ellisen, A. Bardia. Comparison of the Genomic Landscape Between Primary Breast Cancer in African American Versus White Women and the Association of Racial Differences With Tumor Recurrence. Journal of Clinical Oncology, 2015; DOI:10.1200/JCO.2015.62.2126
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Aditya Bardia MBBS, MPH (2015). African American Women Have More Aggressive Breast Cancer Tumor Biology