Evidence map›Paper›PMID 42032819›Full record

ArticleJNCI cancer spectrum2026

Racial disparities and utilization trends of first-line targeted therapies for metastatic breast cancer.

Yehoda M Martei, Kan Chen, Modesty Obasohan, Ronac Mamtani, Erin Aakhus, Lawrence N Shulman, Rebecca A Hubbard, Amy Clark

Abstract read
In one paragraph

Article in JNCI cancer spectrum, 2026. 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. Observational
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

8 authors.

Yehoda M MarteiDivision of Hematology and Oncology, Department of Medicine, University of Pennsylvania, Philadelphia, PA, United States.ORCID 0000-0002-5631-1567
Kan ChenDepartment of Biostatistics, Harvard University, Boston, MA, United States.ORCID 0000-0003-4519-1894
Modesty ObasohanPerelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.ORCID 0009-0007-1880-4276
Ronac MamtaniDivision of Hematology and Oncology, Department of Medicine, University of Pennsylvania, Philadelphia, PA, United States.ORCID 0000-0002-8267-5356
Erin AakhusDivision of Hematology and Oncology, Department of Medicine, University of Pennsylvania, Philadelphia, PA, United States.ORCID 0000-0001-8204-0062
Lawrence N ShulmanDivision of Hematology and Oncology, Department of Medicine, University of Pennsylvania, Philadelphia, PA, United States.ORCID 0000-0001-8661-473X
Rebecca A HubbardDepartment of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA, United States.ORCID 0000-0003-0879-0994
Amy ClarkDivision of Hematology and Oncology, Department of Medicine, University of Pennsylvania, Philadelphia, PA, United States.ORCID 0000-0002-3685-6535

Funding

Flatiron 2021 Health Equities and Health Disparities Research Award and the Breast Cancer Research Foundation NextGen
6 · The paper itself

Abstract

backgroundWe aimed to determine temporal trends and racial disparities in utilization and time to treatment initiation of cyclin dependent kinase 4/6 (CDK4/6) inhibitors and pertuzumab for first-line metastatic breast cancer.

methodsWe extracted data from a nationwide electronic health record-derived deidentified database. Female patients aged 18 years and older with estrogen receptor-positive and HER2-negative or HER2-positive metastatic breast cancer eligible for CDK4/6 inhibitors (March 2015-October 2021) or pertuzumab (July 2012-September 2021) were included. Our outcomes were adjusted temporal trends in the proportion of patients receiving respective therapies using logistic regression with natural cubic splines for time trends and tested for changes in utilization over time within and between racial groups (non-Hispanic White or non-Hispanic Black). Similar models using linear regression estimated mean time to treatment initiation.

resultsA total of 5173 (non-Hispanic White = 4478; non-Hispanic Black = 695) estrogen receptor-positive and HER2-negative and 2321 (non-Hispanic White = 1915; non-Hispanic Black = 406) HER2-positive metastatic breast cancer patients were included. There were statistically significant differences in the proportion initiating CDK4/6 inhibitors over time within racial groups (non-Hispanic White: 23.5%, 95% confidence interval [CI] = 20.1% to 27.3%, in 2015 to 53.8%, 95% CI = 48.6% to 59.0%, in 2021; non-Hispanic Black: 20.6%, 95% CI = 11.9% to 33.0%, in 2015 to 73.6%, 95% CI = 61.7% to 83.0%, in 2021) and between groups (P = .009). There was a statistically significant increase in utilization of pertuzumab within both racial groups over time (P < .001), but no statistically significant difference between groups (P = .45). Time to treatment initiation decreased over time with no statistically significant differences in time to treatment initiation trends between the 2 groups.

conclusionsUtilization of targeted therapies increased over time, however non-Hispanic Black patients were less likely to receive CDK4/6 inhibitors compared with non-Hispanic White. Approximately half of eligible patients did not receive pertuzumab. Further research is needed to understand mediators and design interventions to address underutilization of these therapies and those contributing to racial disparities in CDK4/6 inhibitor utilization.

Indexed as

Antibodies, Monoclonal, HumanizedBreast NeoplasmsHealthcare DisparitiesMolecular Targeted TherapyTyrosine Kinase InhibitorsAdultAgedBlack or African AmericanCyclin-Dependent Kinase 4Cyclin-Dependent Kinase 6Erb-b2 Receptor Tyrosine KinasesFemaleHumansMiddle AgedNeoplasm MetastasisReceptors, EstrogenAntibodies, Monoclonal, HumanizedCDK4 protein, humanCDK6 protein, humanCyclin-Dependent Kinase 4Cyclin-Dependent Kinase 6ERBB2 protein, humanErb-b2 Receptor Tyrosine KinasespertuzumabReceptors, EstrogenTyrosine Kinase Inhibitors

Identifiers

PMID42032819
PMCPMC13265379

What OpenQuestion holds

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LicenceCC BY
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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.