Comparison of Response to Definitive Radiotherapy for Localized Prostate Cancer in Black and White Men

Abstract

IMPORTANCE Black men have a 2-fold increased risk of dying from prostate cancer compared with White men. However, race-specific differences in response to initial treatment remain unknown. OBJECTIVE To compare overall and treatment-specific outcomes of Black and White men with localized prostate cancer receiving definitive radiotherapy (RT).DATA SOURCES A systematic search was performed of relevant published randomized clinical trials

Black Men Receiving Radiotherapy for Localized Prostate Cancer Have Improved Outcomes—Clinical Trial Access or Racial Advantage?

“…Ma et al present a meta-analysis assessing 7 randomized clinical trials of 8814 men who received definitive radiotherapy for localized prostate cancer. The findings suggest that Black men have reduced levels of biochemical recurrence, distant metastasis, and prostate cancer–specific mortality, despite being more likely to have high-risk disease factors at enrollment compared with White men.…”

Comparing the outcomes of robotic assisted radical prostatectomy in black and white men: Experience of a high-volume center

“…The study found that black men received less definitive treatment and had lower cancer-specific mortality than white men, concluding that both ethnic groups achieved equivalent outcomes in universally insured health locations. This is supported by a meta-analysis of seven randomized clinical trials ( 9 ), where the response of black men to radiotherapy (RT) was superior to white men. Considering the above, CaP management should result in equivalent or even superior outcomes in black men compared to matched groups in some circumstances.…”

Exploring new frontiers in prostate cancer research: Report from the 2022 Coffey−Holden prostate cancer academy meeting

“…In just a short time, the POPCaP group has published several papers regarding racial disparities in prostate cancer outcomes, radiation effectiveness, and prostate-specific antigen (PSA)-screening effectiveness. [63][64][65][66] Future studies will utilize nested subcohorts of Veterans with access to somatic next-generation sequencing data, molecular data from tumor specimens, and data from the Million Veteran Program, 67 which links survey data with genotyping, whole-exome sequencing, and whole-genome sequencing data. This "mega-repository," launched in 2011, will enable the study of genotype-lifestyle-exposure correlations at a scale never before done in prostate cancer.…”

“…Efficacy of MRT has been shown to correlate with target expression. In NET, patients with higher somatostatin receptor levels on 68 Ga/ 64 Cu-DOTATATE PET/CT had higher response rates to PRRT, due to receipt of higher radiation dose to tumors, while patients with no uptake do not experience responses. 160 In thyroid cancer patients with minimal or absent Na-I symporter target expression, treatment with MAPK kinase (MEK) 1 and MEK2 inhibitor selumetinib could restore expression of the Na-I symporter, resulting in increased uptake and retention of 131 I.…”

“…The VA population is unique because of the high prevalence of prostate cancer (7%) and the high proportion of Black patients relative to the national population. In just a short time, the POPCaP group has published several papers regarding racial disparities in prostate cancer outcomes, radiation effectiveness, and prostate‐specific antigen (PSA)‐screening effectiveness 63–66 . Future studies will utilize nested subcohorts of Veterans with access to somatic next‐generation sequencing data, molecular data from tumor specimens, and data from the Million Veteran Program, 67 which links survey data with genotyping, whole‐exome sequencing, and whole‐genome sequencing data.…”