Are Genetic Factors Potentially Driving Prostate Cancer in Black Individuals?
Posted: Wednesday, March 10, 2021
The high frequency of mutations in key drivers of prostate cancer may reflect differences in disease biology among racial and ethnic groups, or it may signal socioeconomic factors that delay access to health care in Black patients with more advanced disease, according to findings presented during the virtual edition of the 2021 Genitourinary Cancers Symposium (Abstract 14). The findings from Nicholas Mitsiades, MD, PhD, of the Baylor College of Medicine and Dan L. Duncan Comprehensive Cancer Center, Houston, and colleagues offer a “real-world snapshot” of the genomic profile of patients at a Texas hospital serving a large population of minority patients.
“[This study] highlights the role that next-generation sequencing testing can play to improve [racial/ethnic minority populations’] access to treatment with novel targeted therapies and to biomarker-based precision oncology clinical trials,” the authors added.
In this trial, the authors retrospectively analyzed next-generation sequencing data for germline and/or somatic mutations. They collected samples from 100 patients, 53 of whom were Black, who received androgen-deprivation therapy for locally advanced, biochemically recurrent, or metastatic prostate cancer at Ben Taub Hospital, a safety net hospital in the Houston area. For confirmation, the authors analyzed next-generation sequencing data from a nationwide cohort of 1,211 patients (including 213 Black patients) with metastatic prostate cancer.
Among the Black patients at the Texas hospital, the authors found higher frequencies of AR (18.9%), TP53 (41.5%), SPOP (20.7%), and homologous recombination–repair pathway gene mutations compared with members of other races and ethnicities. Nationwide testing confirmed these findings, as 91 Black patients (42.7%) had at least 1 of 14 homologous recombination–repair pathway genes associated with prostate cancer sensitivity to PARP inhibitors. Nationwide, 347 (34.7%) non-Black patients exhibited at least one of those pathway genes. The authors noted that this difference might be because of a higher frequency of BRCA2 (16.9%), CDK12 (8%), and PALB2 (5.2%) mutations in Black patients.
Disclosure: For full disclosure of the study authors, visit coi.asco.org.
