Abstract PS18-35: Disparities in reporting of race and participation by race in genomic studies

Abstract

Abstract Background: Black/African American(B/AA) women are more likely to die of breast cancer as compared to White (Wh) women but are underrepresented in genomic research. Current genomic research that aims to classify breast cancer in order to personalize treatment in early breast cancer or to identify targets for therapy in advanced breast cancer fails to adequately represent B/AA women and other minority groups. This negatively impacts our current knowledge of breast cancer in non-Wh women and raises questions about the applicability of such testing in minority groups. Objective: To evaluate the frequency of race reporting and representation of non-White women in genomic studies. Methods: This a database study of all PubMed reported genomic testing studies to classify breast cancer for prognostic or predictive purposes. A PubMed search was conducted with articles from inception to the present with the following keyword search terms: “Breast Cancer Gene Expression Assay” AND “Race”, “PAM50” AND “Race”, “MammaPrint” AND “Race”, “Oncotype Dx” AND “Race”, “76 gene prognostic score” AND “Race”, Intrinsic Subtype” AND “Breast Cancer” AND “Race”. This search yielded 129 articles. 31 articles were removed due to lack of relevance. Results: Of the 98 articles remaining after applying inclusion/exclusion criteria, 39 (40%) failed to report race in their analysis. Of the remaining 59 articles, 57 (96.61%) included Wh participants in their study, 54 (91.53%) included B/AA participants, 13 (22.04%) included Hispanics/Latinos, and 20 (33.90%) included Asians. Two of the major clinical trials of widely used testing such as Oncotype Dx and MammaPrint but did not report race in the pivotal studies. The genomic studies that included B/AA women were more likely to be health services research studies. The genomic studies that focused on triple-negative breast cancer (TNBC) were also more likely to have B/AA participants that ranged from 6%-52% of participants. For Oncotype Dx testing, B/AA women were more likely to have a later stage at diagnosis. While the number of patients with low risk was similar in all race groups, B/AA women were more likely to have high Ki-67 with uncertain significance of these findings. Conclusions: A significant number of genomic studies did not report race and ethnicity. Racial and ethnic minorities continue to be under-represented in genomic research and this raises questions about the wider applicability of this research in these populations. Large clinical studies should specifically report the race and ethnicity of participants to inform decision making. In addition, funders should require reporting of race in genomic studies. Citation Format: Niloufar R Khanna, Niharika Dixit. Disparities in reporting of race and participation by race in genomic studies [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS18-35.