Disparities in colorectal cancer in African-Americans vs Whites: Before and after diagnosis

Table 1 Differences in toxicity of the standard treatments for colorectal cancer between whites and AAs

Regimens	Toxicity
Irinotecan and oxaliplatin	FOLFIRI, FOLFOX and IROX are less toxic to AAs than Whites
Fluoropyrimidines	5-FU is less toxic to AAs than Whites
Cetuximab	Whites are more prone to hypersensitivity reactions

AAs: African Americans.

Table 2 Differences in toxicity of the standard treatments for colorectal cancer between Whites and African Americans

Regimens	Toxicity	Difference	Reference
Irinotecan and oxaliplatin	FOLFIRI, FOLFOX and IROX are less toxic to AAs than Whites	34% vs 48%, P = 0.004, for severe toxicity	[95]
		5% vs 17%, P = 0.004 for diarrhea
Fluoropyrimidines	5-FU regimens in the adjuvant setting differed between AA and Whites, with AA experiencing statistically significantly lower rates	Diarrhea (P < 0.001)	[98]
		Nausea (P < 0.001)
		Vomiting (P = 0.01)
		Stomatitis (P < 0.001)
		Overall toxicity (P = 0.005)
DPD deficiency	AA, particularly AA women, have significantly reduced DPD enzyme activity compared with Whites, which may predispose this population to less 5-FU toxicity	-	[99]
Cetuximab	In a retrospective analysis, it was shown race was strongly associated with HSR to cetuximab among patients with CRC and head and neck cancer, with Whites experiencing HSR more frequently than AA	(Fisher exact) P = 0.017	[100]

HSR: Hypersensitivity reactions; AA: African American.