The outcomes of metastatic hormone-sensitive prostate cancer (mHSPC) have significantly improved through treatment intensification, yet Black representation in those studies is suboptimal.
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.
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%).
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.
The oncologist. 2022 Mar 11 [Epub]
Meredith N Freeman, Albert Jang, Jason Zhu, Farhad Sanati, Lakshminarayanan Nandagopal, Deepak Ravindranathan, Arpita Desai, Audrey Phone, Roberto Nussenzveig, Ellen Jaeger, Sydney A Caputo, Vadim S Koshkin, Umang Swami, Arnab Basu, Mehmet A Bilen, Neeraj Agarwal, Oliver Sartor, Earle F Burgess, Pedro C Barata
Tulane Cancer Center, Tulane University School of Medicine, New Orleans, LA, USA., Levine Cancer Institute, Atrium Health, Charlotte, NC, USA., University Hospitals Seidman Cancer Center, Cleveland, OH, USA., University of Alabama at Birmingham, Birmingham, AL, USA., Winship Cancer Institute of Emory University, Atlanta, GA, USA., University of California San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA., Huntsman Cancer Institute-University of Utah Health Care, Salt Lake City, UT, USA.