title: Racial differences in acute toxicities of neoadjuvant or adjuvant chemotherapy in patients with early-stage breast cancer.
abstract: BACKGROUND
  Racial disparities in breast cancer outcomes are attributed to differences in baseline tumour characteristics and biology, stage, age, ethnic background and socioeconomic factors. However, little is known about racial differences in treatment-related toxicities. We hypothesised that racial/ethnic differences result in differential tolerance to chemotherapy potentially, leading to compromised dose intensity/density of chemotherapy in patients with early-stage breast cancer.
  
  
  METHODS
  Data were collected from patients treated at five international centers for early breast cancer with the same adjuvant/neoadjuvant chemotherapy (FEC 100: fluorouracil 500mg/m(2), epirubicin 100mg/m(2), and cyclophosphamide 500mg/m(2),every 21d for 3-6 cycles). Toxicities were assessed by first episode of ⩾grade 2 toxicity.
  
  
  RESULTS
  Toxicities were compared according to four race/ethnicity groups (103 Caucasian, 30 African American, 164 Asian, and 34 Hispanic patients). Tumour characteristics across four race/ethnicity groups were similar. Asians had a significantly higher rate of grade 3 haematologic toxicity than Caucasians, African Americans or Hispanic women (32%, 16%, 10%, and 15%, respectively; p<0.05). In multivariate analysis, only lower BMI was associated with a higher incidence of ⩾grade 3 toxicities. However, no significant differences in chemotherapy dose intensity/density were shown across the four race/ethnicity groups.
  
  
  CONCLUSIONS
  Racial differences in acute toxicity were noted in women with breast cancer who were treated with FEC 100 chemotherapy, suggesting that extrapolating toxicities from chemotherapy across ethnicities is not possible and emphasising the need to validate safety of chemotherapeutic regimens in patients of different ethnicities by enhancing the participation of minorities in clinical trials.
authors: Department of Women's Oncology, Breast Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
authors: Hyo Sook
authors: HS
authors: Han
authors: Isildinha M
authors: IM
authors: Reis
authors: Wei
authors: W
authors: Zhao
authors: Katsumasa
authors: K
authors: Kuroi
authors: Masakazu
authors: M
authors: Toi
authors: Eiji
authors: E
authors: Suzuki
authors: Rachel
authors: R
authors: Syme
authors: Louis
authors: L
authors: Chow
authors: Adrian Y S
authors: AY
authors: Yip
authors: Stefan
authors: S
authors: Glück
mesh_terms: D000328:Adult; D001741:Black or African American; D000368:Aged; D000704:Analysis of Variance; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D001213:Asian; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000208:ethnology* / Q000473:pathology; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D003520:Cyclophosphamide / Q000009:adverse effects; D015251:Epirubicin / Q000009:adverse effects; D005260:Female; D005472:Fluorouracil / Q000009:adverse effects; D006630:Hispanic or Latino; D006801:Humans; D008875:Middle Aged; D044465:White People; D055815:Young Adult
chemical_list: D015251:Epirubicin; D003520:Cyclophosphamide; D005472:Fluorouracil