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. 2023 Dec:2:100022.
doi: 10.1016/j.ejcped.2023.100022. Epub 2023 Jul 20.

Persistence of Racial and Ethnic Disparities in Risk and Survival for Patients with Neuroblastoma over Two Decades

Mohansrinivas Chennakesavalu  1 , Caileigh Pudela  2 , Mark A Applebaum  3 , Sang Mee Lee  4 , Yan Che  4 , Arlene Naranjo  5 , Julie R Park  6 , Samuel L Volchenboum  3 , Tara O Henderson  3 , Susan L Cohn  3 , Ami V Desai  3
Affiliations

Persistence of Racial and Ethnic Disparities in Risk and Survival for Patients with Neuroblastoma over Two Decades

Mohansrinivas Chennakesavalu et al. EJC Paediatr Oncol. 2023 Dec.

Abstract

Background: Racial/ethnic survival disparities in neuroblastoma were first reported more than a decade ago. We sought to investigate if these disparities have persisted with current era therapy.

Methods: Two patient cohorts were identified in the International Neuroblastoma Risk Group Data Commons (INRGdc) (Cohort 1: diagnosed 2001-2009, n=4359; Cohort 2: diagnosed 2010-2019, n=4891). Chi-squared tests were used to assess the relationship between race/ethnicity and clinical and biologic features. Survival was estimated by the Kaplan-Meier method. Cox proportional hazards regression analyses were performed to investigate the association between racial/ethnic groups and prognostic markers.

Results: Significantly higher 5-year event-free survival (EFS) and overall survival (OS) were observed for Cohort 2 compared to Cohort 1 (P<0.001 and P<0.001, respectively). Compared to White patients, Black patients in both cohorts had a higher proportion of high-risk disease (Cohort 1: P<0.001; Cohort 2: P<0.001) and worse EFS (Cohort 1: P<0.001; Cohort 2 P<0.001) and OS (Cohort 1: P<0.001; Cohort 2: P<0.001). In Cohort 1, Native Americans also had a higher proportion of high-risk disease (P=0.03) and inferior EFS/OS. No significant survival disparities were observed for low- or intermediate-risk patients in either cohort or high-risk patients in Cohort 1. Hispanic patients with high-risk disease in Cohort 2 had significantly inferior OS (P=0.047). Significantly worse OS, but not EFS, (P=0.006 and P=0.02, respectively) was also observed among Black and Hispanic patients assigned to receive post-Consolidation dinutuximab on clinical trials (n=885).

Conclusion: Racial/ethnic survival disparities have persisted over time and were observed among high-risk patients assigned to receive post-Consolidation dinutuximab.

Keywords: Race; disparities; ethnicity; neuroblastoma.

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Conflict of interest statement

Conflict of Interest/Financial Disclosures: Mark A. Applebaum: consultancy fees from Illumina Radiopharmaceuticals. Arlene Naranjo: serves on a DSMC for Novartis. Sam L. Volchenboum: Founder of Litmus Health, Inc. Tara O. Henderson: research funding from Seattle Genetics. Susan L. Cohn: stock ownership in Pfizer, Merck, and Lilly; served on advisory boards for Y-mAbs Therapeutics and US World Meds. Ami V. Desai: stock ownership in Pfizer and Viatris; consultancy/advisory board fees from Ology Medical Education, YMabs Therapeutics, Glaxo Smith-Kline; travel/accommodation expenses from YMabs Therapeutics. The remaining authors made no disclosures.

Figures

FIGURE 1:
FIGURE 1:. Consort Diagram.
INRGdc, International Neuroblastoma Risk Group Data Commons.
FIGURE 2:
FIGURE 2:. Survival analysis of Cohort 1 and 2 patients.
A) Event-free and B) overall survival for patients in Cohort 1 (Year of Diagnosis: 2001–2009; n=4,210) and Cohort 2 (Year of Diagnosis: 2001–2009; n=4,298).
FIGURE 3:
FIGURE 3:. Survival analysis of Cohort 1 and 2 patients, by race/ethnicity.
A) Event-free and B) overall survival by race/ethnicity for Cohort 1 patients. C) Event-free and D) overall survival by race/ethnicity for Cohort 2 patients.
FIGURE 4:
FIGURE 4:. Survival analysis of high-risk patients diagnosed between 2001–2014 assigned to receive post-Consolidation dinutuximab, by race/ethnicity.
A) Event-free and B) overall survival by race/ethnicity for high-risk patients diagnosed between 2001–2014 assigned to receive post-Consolidation dinutuximab (n=885).
See this image and copyright information in PMC

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