Prevalence and survival of TNBC patients vs non-TNBC patients in India: A multi-centric real-world experience based study.

Abstract

e13064 Background: Triple-Negative Breast cancer (TNBC) is a highly aggressive form of breast cancer, characterized by the lack of expression of Estrogen Receptor (ER), Progesterone Receptor (PR), and Human Epidermal Growth Factor-2 (HER-2). Patients with TNBC do not benefit from hormonal or Trastuzumab therapy due to the lack of appropriate targets for these drugs. The current retrospective multicentric hospital-based study at HCG, India, aims to analyze the available treatment paradigms in TNBC patients in real-world evidence. Methods: Data from 3180 female breast cancer patients was collected and compiled from various medical records department (MRD) and hospital database from three HCG centers. The data comprised demographic and clinicopathological details, treatment details and survival information. In addition, the clinical and pathological parameters and survival outcomes were compared between TNBC and non-TNBC patients. Results: About 22.92% (729/3180) patients had TNBC, and 77.08% (2451/3180) patients had designated as non-TNBC. In the TNBC subgroup, 22.36% (163/729) patients belonged to the younger age group (< 40 years), 65.98% (481/729) patients were in the 41-65 age group, while 11.66% (85/729) patients were > 65 years old. Whereas the age-wise distribution in the non-TNBC group was as follows: < 40 years- 15.46% (379/2451) patients, 41-65 years- 70.34% (1724/2451) patients, and > 65 years- 14.2% (348/2451) patients. In the present cohort, TNBC and non-TNBC groups' mean age was 51.06 ± 12.15 years and 53.29 ± 11.55 years, with no statistical significance. About 11.8% (86/729) of patients in the TNBC group and 10.4% (255/2451) of patients in the non-TNBC group opted for neo-adjuvant chemotherapy. About 32.37% of patients in TNBC and 37.45% of patients in the non-TNBC group underwent surgery. The 5-year OS was 68.58% and 83.41% for TNBC and non-TNBC patients, respectively, with a median 5-year survival of 2.13 years (95% CI 2.528-3.204) for TNBC patients whereas 5-year median survival of 2.096 (95% CI 1.36-4.368). The mean survival in TNBC patients < 40 years was 10.14 years, which was significantly lower when compared to patients in the 41-65 years (14.12 years) and > 65 years (19.45 years). Also, patients in the TNBC group who underwent surgery had a higher mean survival of 16.72 years than those who did not opt for surgery (14.49 years). Further, chemotherapy and radiotherapy also increased the life expectancy in patients in both the TNBC and non-TNBC groups. Conclusions: In the present study cohort, TNBC distribution in the at the HCG center in the Indian subcontinent is similar to that of the western population (23% in the US and the UK). Adjuvant chemotherapy and radiotherapy were significantly higher among TNBC cases than non-TNBC cases. Lack of patient consent or proper patient follow-up further reduces survival