Impact of Race, Socioeconomic Status, and Clinicopathologic Features on Clinical Outcomes in Triple-Negative Breast Cancer in the ECOG-ACRIN EA1131 Trial

A higher incidence of triple negative breast cancer (TNBC) and worse social determinants of health (SDOH) both contribute to racial survival disparities among Black women diagnosed with breast cancer. A post hoc analysis of the ECOG-ACRIN EA1131 study (adjuvant platinum versus capecitabine in stage II-III TNBC with residual disease after neoadjuvant chemotherapy) evaluated racial disparities in disease free survival (DFS) and overall survival (OS) among Black and White patients. Of 415 patients enrolled in EA1131, 376 were included in this analysis (308 White [82%] and 68 Black [18%]). Common characteristics included basal-subtype TNBC (77%), grade 3 disease (71%), residual stage II disease (49%), private insurance (70%), and a BMI ≥30 (49%). There were no racial differences in grade, clinical or pathological stage. Black patients were more likely to have basal-subtype TNBC (89% vs 75%; p=0.009), a BMI ≥30 (62% vs 46%; p=0.026), to reside within the lowest neighborhood socioeconomic index (nSES) quartile (39% vs 22%; p=0.008), and have Medicaid (32% vs 13%; p