The relationship between treatment intensity and characteristics of patients with early-stage breast cancer.
Differences in treatment intensity were observed for patients with differing demographic characteristics. Further research is needed to determine lack of representation in clinical trials impacts on prescribing patterns, regimen intensity, and survival.
Clinical trials are used to generate standard-of-care, yet often do not reflect patient populations treated in real-world settings. Elderly patients or patients of color are often underrepresented in trials, which may impact what types of treatments are prescribed. This retrospective cross-sectional study included women with a stage I-III breast cancer from American Society of Clinical Oncology’s CancerLinQ database treated by chemotherapy. A model estimating the likelihood of intensity was calculated using log-binomial regression, in order to produce relative risks. The models were adjusted for patient demographics and cancer stage.
Of more than 24,000 patients, 51% had ER+HER2-, 20% ER-HER2-, and 29% HER2+ breast cancer. Adjusted for the other covariates, patients who were Black were more likely to receive high-intensity treatment than patients who were White. Additionally, older adults were more likely to receive low-intensity treatment, with 42% of patients over 70 years old receiving low intensity treatment, and 29% of patients between 40-69 years old received low intensity treatment.