Does Race Affect Response to Treatment in Metastatic Castration-Resistant Prostate Cancer?
Posted: Tuesday, June 22, 2021
According to findings from a multicenter study presented in Cancer, radiographic progression-free and overall survival rates were similar between Black men and White men with metastatic castration-resistant prostate cancer who were treated with the hormone therapy abiraterone acetate plus prednisone. Andrew J. Armstrong, MD, of Duke University School of Medicine, Durham, North Carolina, and colleagues sought to demonstrate the feasibility of enrolling equal numbers of Black men and report and evaluate outcomes relative to race.
The study included 100 men who self-identified as either Black (n = 50) or White (n = 50). At a median follow-up of 24.8 months, the median radiographic progression-free survival was 16.6 months for Black patients and 16.8 months for White patients. Overall survival rates were similarly comparable at 35.9 months and 35.7 months, respectively. Time to prostate-specific antigen (PSA) disease progression was 16.6 months for Black patients and 11.5 months for White patients. Black patients had a slightly higher estimated rate of PSA decline by at least 50%, at 75% versus 66% for White patients. Black patients also had an increased rate of PSA declines to < 0.2 ng/mL at 26% versus 10% for White patients. Grades 3 and 4 hypertension, hypokalemia, and hyperglycemia were increased among Black patients.
A defining feature of this study was its acceptance of patients with comorbidities, who are often excluded from therapeutic studies due to a perceived increase in complication risk. Because Black men with prostate cancer are more likely to have comorbidities such as hypertension, they are often excluded from studies despite this population’s disproportionately increased risk of disease mortality.
“If there is a subgroup of patients with an ancestry-based predisposition for potential better response, we need to understand that,” stated lead author Daniel George, MD, also of Duke University, in a Duke Health press release. “But to do so, we will need greater genetic diversity in our future study populations, especially among those with African ancestry.”
Disclosure: For full disclosures of the study authors, visit acsjournals.onlinelibrary.wiley.com.
