Impact of Race on Survival in Metastatic Castration-Resistant Prostate Cancer
Posted: Wednesday, February 27, 2019
Black men with metastatic castration-resistant prostate cancer treated with regimens containing docetaxel and prednisone had a decreased risk of death compared with white men so treated, according to a study published in the Journal of Clinical Oncology. Previous studies of men with localized prostate cancer have indicated a shorter overall survival for black men.
“This large meta-analysis provides evidence that black men with [metastatic castration-resistant prostate cancer] treated with [docetaxel plus prednisone] in clinical trials had improved survival outcomes compared with white men when adjusted for baseline prognostic factors,” stated Susan Halabi, PhD, of Duke University Medical Center, Durham, North Carolina, and colleagues. “The mechanism for these differences is not known.”
The study included data from 8,820 men with metastatic castration-resistant prostate cancer from 9 phase III trials, including 7,528 white men (85%), 500 black men (6%), and 424 Asian men (5%). All participants were treated with docetaxel plus prednisone or a docetaxel plus prednisone–containing regimen.
Overall, black men were younger and had a worse performance status, higher testosterone and prostate-specific antigen levels, and lower hemoglobin levels than white men. Despite these differences, the median overall survival was longer for black men at 21.2 months versus 21.0 months for black and white men, respectively (hazard ratio = 0.81, P < .001). The hazard ratios favored black men in six of the nine trials included in the analysis.
“Our understanding of these differences is limited and underscores the need for additional research,” concluded Dr. Halabi and colleagues.
Disclosure: The study authors’ disclosure information may be found at ascopubs.org.