In a letter to the editor published in The New England Journal of Medicine, Brandon A. Mahal, MD, and colleagues described genomic differences in prostate cancer in Black, White, and Asian men.
Brandon A. Mahal, MD
Study Details
The study involved next-generation sequencing data from patients who had been treated for prostate cancer at Memorial Sloan Kettering Cancer Center or Dana-Farber Cancer Institute. Among the total of 2,393 patients, 2,109 were White; 204, Black; and 80, Asian. A total of 1,484 patients had primary disease (1,308 White, 133 Black, and 43 Asian) and 909 had metastatic disease (801 White, 71 Black, and 37 Asian).
Key Findings in Primary Disease
Key Findings in Metastatic Disease
The investigators concluded, “Clinically significant alterations may occur at different frequencies across races. Notably, Black men with metastatic prostate cancer were more likely than either White or Asian men to have tumor mutations in AR, along with mutations in DNA-repair genes and actionable genetic mutations. This finding could have implications for prognosis, response to therapy, and enrollment of minority populations in clinical trials and precision oncology studies…To support and further explore the implications of these findings, we will need studies involving a larger number of non-White men for whom data are available regarding the effects of treatment and results from histopathological analysis on outcomes. The evaluation of such data could help to prevent a worsening of racial disparities in the diagnosis and treatment of prostate cancer.”
Disclosure: The study was supported by the American Society for Radiation Oncology, Prostate Cancer Foundation, U.S. Department of Defense, and National Institutes of Health. For full disclosures of the study authors, visit nejm.org.
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