Impact of Genetic Ancestry on Outcomes in ECOG-ACRIN-5103

PurposeRacial disparity in breast cancer outcomes exists between African American and white women in the United States. We have evaluated the impact of genetically determined ancestry on disparity in efficacy and therapy-induced toxicity for patients with breast cancer in the context of a randomized, phase III adjuvant trial.MethodsThis study compared outcomes between 386 patients of African ancestry (AA) and 2,473 patients of European ancestry (EA) in a randomized, phase III breast cancer trial, ECOG-ACRIN-5103. The primary efficacy end point, invasive disease–free survival (DFS), and clinically significant toxicities were compared, including anthracycline-induced congestive heart failure, taxane-induced peripheral neuropathy (TIPN), and bevacizumab-induced hypertension.ResultsOverall, AAs had significantly inferior DFS (P = .002; hazard ratio, 1.5) compared with EAs. This was significant in the estrogen receptor–positive subgroup (P = .03), with a similar, nonsignificant trend for those who had triple-n...