Prostate Cancer Black Vs. White Patients is a very fitting title. Why? Because African American men are more likely to both develop and die from prostate cancer than white men. North Carolina’s African American men are almost 20% more likely than their white counterparts to die from prostate cancer. After controlling for access to care, much of the disparity still exists. The Patierno laboratory, Duke Cancer Institute (DCI), has previously used this disparity between African American men and white men to better understand the molecular basis of tumor aggressiveness. They also collaborated with the Lee laboratory at George Washington University to identify biomarkers and molecular targets which could lead to new treatments and prevention.
Black men are twice as likely to get prostate cancer and 50% more likely to be diagnosed in their lifetimes. Vincent Laudone is the Chief of Surgery at MSK’s Josie Robertson Surgery Center. He explains that many factors can increase or decrease the chance of developing prostate cancer. Age, family history and smoking are all factors that can increase the risk of developing prostate cancer.
Differing Outcomes Between Black And White Prostate Patients
New Research Presented 2021 Study
The 2021 American Society of Clinical Oncology Annual Meeting presented new research that provides a better understanding of the factors that drive differences in mortality and outcomes among prostate cancer patients. Both are more common in black men who have prostate cancer.
It is well-documented that racial disparities exist in terms of health outcomes, including cancer. It’s not clear how socioeconomic or biological factors influence these disparities or whether genomics and precision medicine can help.
New research from the 2021 American Society of Clinical Oncology Annual Meeting (ASCO) is now providing a better understanding of how mortality and outcomes differ for prostate cancer patients.
Black men have a 18.2% chance of getting prostate cancer in their lifetime, compared to 13.3% for White men. Black men are significantly more likely than White men to develop prostate cancer (4.4% vs. 2.4%).
Advances in genomics and precision medicines may improve the outcomes and risk prediction for many types of cancers. However, they could actually increase these disparities.One study presented in abstract form by Foundation Medicine and collaborators Mahal, MD, Assistant Professor of Radiation Oncology and Assistant Direct of Community Outreach and Engagement at Sylvester Comprehensive Cancer Center examined how patterns of comprehensive genomic profiling and treatment differed by race.
Data from the largest cohort of this kind revealed that men of African descent were less likely to be enrolled in clinical trials and receive comprehensive genomic profiling early on.
Researchers analyzed data from over 11,000 prostate cancer patients using comprehensive genomic profiling. This included 1400 African-American men and 9200 American patients of European descent. They also analysed real-world data from almost 900 patients in Flatiron Health’s clinic and Foundation Medicine genome database.
Both ancestry types had similar rates of alterations to BRCA1/2 and AR DNA damage response pathway genes and actionable genes. While both were equally likely to be treated with immunotherapy or PARP inhibitor therapy, men of African descent were almost three times less likely to be enrolled in clinical trials for investigational treatments than men of European descent (11% to 30%). This was true even for men with actionable alterations (1%, 6%).
Mahal explains :“Men of African ancestry experience the greatest burden of disease in prostate cancer, and this research indicates that differences in cancer care are not solely based on biological factors, but rather points to socioeconomic factors such as access to comprehensive genomic profiling and clinical trial enrollment,” Mahal said in a statement. “To ensure equitable opportunities for precision medicine, we need to expand access to and awareness of advances that impact patient care and outcomes, including timely use of genomic testing to help make informed treatment decisions.”
Mahal also explained in a separate presentation that most genomic studies are based upon Eurocentric cohorts. This means that approximately 80% of patients participating in the genome-wise associations study (GWAS), are of European descent despite representing 16% of the population. However, this leaves the possibility of worsening disparities because of a lack of representative studies.