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- Title
Multi-institutional Analysis of the Clinical and Genomic Characteristics of Black Patients with Metastatic Hormone-Sensitive Prostate Cancer.
- Authors
Freeman, Meredith N; Jang, Albert; Zhu, Jason; Sanati, Farhad; Nandagopal, Lakshminarayanan; Ravindranathan, Deepak; Desai, Arpita; Phone, Audrey; Nussenzveig, Roberto; Jaeger, Ellen; Caputo, Sydney A; Koshkin, Vadim S; Swami, Umang; Basu, Arnab; Bilen, Mehmet A; Agarwal, Neeraj; Sartor, Oliver; Burgess, Earle F; Barata, Pedro C
- Abstract
Background The outcomes of metastatic hormone-sensitive prostate cancer (mHSPC) have significantly improved through treatment intensification, yet Black representation in those studies is suboptimal. Methods A multi-institutional, retrospective analysis of Black men with mHSPC was conducted, focusing on baseline demographics, treatment patterns, genomic profiles, clinical outcomes including prostate-specific antigen response, time to castrate-resistant prostate cancer (CRPC), and subsequent treatments. Results A total of 107 patients, median age 64 years, 62% with de novo metastases at diagnosis and 64% with high-volume disease, were included. Twenty-nine patients (27%) were treated with androgen deprivation therapy (ADT) with and without first generation anti-androgens, while 20%, 38% and 5% received chemotherapy, abiraterone, and enzalutamide, respectively. At time of data cut-off, 57 (54%) patients had developed CRPC, with a median time to CRPC of 25.4 months (95% CI 20.3-30.4). The median time to CRPC was 46.3 months (18.9-73.7) and 23.4 months (18.6-28.2) for patients who received ADT with or without first-generation anti-androgens and treatment intensification, respectively. The 2-year survival rate was 93.3%, and estimated median overall survival of was 74.9 months (95% CI, 68.7-81.0). Most patients (90%) underwent germline testing; the most frequent known alterations were found within the DNA repair group of genes. Somatic testing revealed pathogenic alterations of interest, notably TP53 (24%) and CDK12 (12%). Conclusion In our cohort, Black men with mHSPC presented with a high proportion of de novo metastases and high-volume disease. Treatment outcomes were very favorable with ADT-based regimens. The genomic landscape suggests different molecular profile relative to White patients with potential therapeutic implications.
- Subjects
RESEARCH; CONFIDENCE intervals; ANTIANDROGENS; DNA; SEQUENCE analysis; BLACK people; CANCER chemotherapy; METASTASIS; ABIRATERONE acetate; RACE; TREATMENT effectiveness; SYMPTOMS; GENOMICS; DESCRIPTIVE statistics; PROSTATE-specific antigen; WHITE people; HEALTH equity; DATA analysis software; PROSTATE tumors
- Publication
Oncologist, 2022, Vol 27, Issue 3, p220
- ISSN
1083-7159
- Publication type
Article
- DOI
10.1093/oncolo/oyab057