Evidence map›Paper›PMID 38703287›Full record

ArticleBreast cancer research and treatment2024

Disparities in PI3K/mTOR inhibitor use, toxicities, and outcomes among patients with metastatic breast cancer.

Claire Sathe, Melissa K Accordino, David DeStephano, Mansi Shah, Jason D Wright, Dawn L Hershman

Abstract read
In one paragraph

Article in Breast cancer research and treatment, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Claire SatheHerbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY, USA. ds1099@cumc.columbia.edu.
Melissa K AccordinoHerbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY, USA.
David DeStephanoHerbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY, USA.
Mansi ShahVagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA.
Jason D WrightHerbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY, USA.
Dawn L HershmanHerbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY, USA.

Funding

Tumor Biology and Microenvironment ProgramP30CA013696 · NCI · COLUMBIA UNIV NEW YORK MORNINGSIDE · PI Anil K Rustgi · 1985 to 2026
$115.3M
NCI NIH HHS P30 CA013696
6 · The paper itself

Abstract

purposeNovel agents such as PI3K and mTOR inhibitors (PI3K/mTORi) have expanded treatment options in metastatic breast cancer (MBC). Nevertheless, mortality rates remain disproportionately high for Black patients and patients with lower socioeconomic status. Furthermore, clinical trials for these novel agents lacked diversity, so their toxicity profile in minority populations is uncertain.

methodsWe conducted a retrospective analysis of EHR-derived data from the Flatiron Health Database for patients with HR+, HER2- MBC. Multivariable logistic regression was used to evaluate factors associated with PI3K/mTORi use and toxicity outcomes.

resultsA total of 9169 patients with MBC were included in our analysis, of which 1780 (19.4%) received a PI3K/mTORi. We estimated the conditional total effect of insurance through Medicaid, and found lower odds of use of PI3K/mTORi among patients on Medicaid compared to those with commercial insurance (OR 0.73, 95% CI 0.54-0.99, p = 0.049). Odds of PI3K/mTORi use were higher for patients treated at an academic center (OR 1.28, CI 1.06-1.55, p = 0.01). Modeled as a controlled direct effect, Black/African American (Black/AA) race had no impact on odds of PI3K/mTOR use. Black/AA patients had twice the odds of developing hyperglycemia on PI3K/mTORi compared to White patients (OR 2.02, CI 1.24-3.39, p < 0.01).

conclusionThis analysis of real-world data suggests that the use of PI3K/mTORi is influenced by socioeconomic factors. We also found racial disparities in toxicity outcomes, with Black/AA patients having twice the risk of hyperglycemia. Our findings call for greater efforts to ensure access to novel treatments and improve their tolerability in diverse populations.

Indexed as

Breast NeoplasmsMTOR InhibitorsPhosphoinositide-3 Kinase InhibitorsAdultAgedFemaleHealthcare DisparitiesHumansMiddle AgedNeoplasm MetastasisRetrospective StudiesTOR Serine-Threonine KinasesTreatment OutcomeUnited StatesMTOR InhibitorsMTOR protein, humanPhosphoinositide-3 Kinase InhibitorsTOR Serine-Threonine KinasesHealthcare disparitiesMetastatic breast cancerNovel antineoplastic agentsToxicities

Identifiers

PMID38703287
PMCPMC13101175

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.