New Study Shows Treatment Patterns, Not Genetics, Drive Prostate Cancer Disparities

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Overview of study design and overall genomic status. (A) Study overview. The study included 11,741 prostate cancer patients who underwent CGP to assess ancestry-based genomic patterns, and 1,234 independent metastatic prostate cancer cohorts from the Flatiron Health Foundation of Medicine (1,017 patients of European descent, including 130 patients of African descent). A clinical genomic database for evaluating CGP utilization and treatment patterns. (B) Oncoplot showing the most frequently altered genes across the prostate cancer CGP cohort. Annotated for tumor mutational burden, microsatellite instability status, and predicted ancestry. Identified genetic alterations in each sample are displayed based on their variants. CGP=Comprehensive Genomic Profiling. SNP = single nucleotide polymorphism. credit: lancet digital health (2023). DOI: 10.1016/S2589-7500(23)00053-5

Why do African men die more often from prostate cancer than other men and experience the greatest burden of advanced prostate disease worldwide?

In a large retrospective analysis by researchers at the Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine, differences in care, not genetics, explain disparities in advanced prostate cancer between African and European men suggested that it is likely.

A study of nearly 13,000 men with advanced prostate cancer found that lancet digital health This is one of the most comprehensive studies to date on prostate cancer disparities among men of these ethnicities.

“This is the largest and most representative study of advanced prostate cancer in men of African and European descent,” said Dr. Brandon Mahal, assistant professor of radiation oncology at Sylvester College and the study’s lead author. I believe it is genomic research,” he said.

He continued, “The data clearly show that there are no notable differences in gene mutations among the progenitors targeted for treatment, and that these mutations likely cause disparities in advanced prostate cancer.” It suggests that it is not,” he said.

Mahal et al. found that despite the increased risk of developing malignant prostate disease, African men were less likely to undergo comprehensive genetic profiling of their tumors during the early stages of treatment. This means that European countries have not benefited as much from advanced testing that could guide gene-targeted therapies and improve patient outcomes. Alternatively, as the cancer progresses, it may tolerate other, less effective treatments.

And men of African descent are less likely than men of European descent to participate in prostate cancer clinical trials, Mahal noted. Prostate cancer usually includes newer and more effective treatments for advanced disease.

“We’ve known for decades that prostate cancer disparities are among the largest disparities seen across all cancer types. This study addresses these disparities. It helps us focus our efforts on what we need to do,” he said, adding that future research will: Genomics research should not be neglected.

“While this study focuses on advanced prostate cancer and has less focus on genomics as a reason for the disparity, there are still reasons to study the role of genomics in men’s risk of developing prostate cancer. ‘Mr Mahal concluded.

For more information:
Smruthy Sivakumar et al, Comprehensive genomic profiling and treatment patterns across ancestry in advanced prostate cancer: a large retrospective analysis. lancet digital health (2023). DOI: 10.1016/S2589-7500(23)00053-5

Courtesy of Sylvester Comprehensive Cancer Center

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