Adriana C Vidal1, Lauren E Howard1,2,3, Amanda De Hoedt2, Christopher J Kane4, Martha K Terris5,6, William J Aronson7,8, Matthew R Cooperberg9, Christopher L Amling10, Stanislav Lechpammer11, Scott C Flanders12, Stephen J Freedland1,2. 1. Division of Urology, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California. 2. Urology Section, Veterans Affairs Medical Center, Durham, North Carolina. 3. Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, North Carolina. 4. Urology Department, University of California-San Diego Health System, San Diego, California. 5. Section of Urology, Veterans Affairs Medical Center, Augusta, Georgia. 6. Section of Urology, Medical College of Georgia, Augusta, Georgia. 7. Urology Section, Department of Surgery, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California. 8. Department of Urology, University of California-Los Angeles School of Medicine, Los Angeles, California. 9. Department of Urology, University of California-Los Angeles Helen Diller Family Comprehensive Cancer Center, San Francisco, California. 10. Division of Urology, Oregon Health Sciences University, Portland, Oregon. 11. Medical Affairs Oncology, Pfizer, Inc, San Francisco, California. 12. Health Economics and Clinical Outcomes Research-Oncology, Astellas Pharma, Inc, Northbrook, Illinois.
Abstract
BACKGROUND: In this study among men who underwent radical prostatectomy (RP), African American men (AAM) were 28% more likely to develop recurrent disease compared with Caucasian men (CM). However, among those who had nonmetastatic, castration-resistant prostate cancer (CRPC), race did not predict metastases or overall survival. Whether race predicts metastases among men who receive androgen-deprivation therapy (ADT) after a biochemical recurrence (BCR) (ie, before CRPC but after BCR) is untested. METHODS: The authors identified 595 AAM and CM who received ADT for a BCR that developed after RP between 1988 and 2015 in the Shared Equal-Access Regional Cancer Hospital (SEARCH) database. Univariable and multivariable Cox models were used to test the association between race and the time from ADT to metastases. Secondary outcomes included the time to CRPC, all-cause mortality, and prostate cancer-specific mortality. RESULTS: During a median follow-up of 66 months after ADT, 62 of 354 CM (18%) and 38 of 241 AAM (16%) developed metastases. AAM were younger at the time they received ADT (63 vs 67 years; P < .001), had received ADT in a more recent year (2008 vs 2006; P < .001), had higher prostate-specific antigen levels at RP (11.1 vs 9.2 ng/mL; P < .001), lower pathologic Gleason scores (P = .004), and less extracapsular extension (38% vs 48%; P = .022). On multivariable analysis, there was no association between race and metastases (hazard radio, 1.20; P = .45) or any of the other secondary outcomes (all P > .5). CONCLUSIONS: Among veterans who received ADT post-BCR after RP, race was not a predictor of metastases or other adverse outcomes. The current findings suggest that research efforts to understand racial differences in prostate cancer biology should focus on early stages of the disease (ie, closer to the time of diagnosis).
BACKGROUND: In this study among men who underwent radical prostatectomy (RP), African American men (AAM) were 28% more likely to develop recurrent disease compared with Caucasian men (CM). However, among those who had nonmetastatic, castration-resistant prostate cancer (CRPC), race did not predict metastases or overall survival. Whether race predicts metastases among men who receive androgen-deprivation therapy (ADT) after a biochemical recurrence (BCR) (ie, before CRPC but after BCR) is untested. METHODS: The authors identified 595 AAM and CM who received ADT for a BCR that developed after RP between 1988 and 2015 in the Shared Equal-Access Regional Cancer Hospital (SEARCH) database. Univariable and multivariable Cox models were used to test the association between race and the time from ADT to metastases. Secondary outcomes included the time to CRPC, all-cause mortality, and prostate cancer-specific mortality. RESULTS: During a median follow-up of 66 months after ADT, 62 of 354 CM (18%) and 38 of 241 AAM (16%) developed metastases. AAM were younger at the time they received ADT (63 vs 67 years; P < .001), had received ADT in a more recent year (2008 vs 2006; P < .001), had higher prostate-specific antigen levels at RP (11.1 vs 9.2 ng/mL; P < .001), lower pathologic Gleason scores (P = .004), and less extracapsular extension (38% vs 48%; P = .022). On multivariable analysis, there was no association between race and metastases (hazard radio, 1.20; P = .45) or any of the other secondary outcomes (all P > .5). CONCLUSIONS: Among veterans who received ADT post-BCR after RP, race was not a predictor of metastases or other adverse outcomes. The current findings suggest that research efforts to understand racial differences in prostate cancer biology should focus on early stages of the disease (ie, closer to the time of diagnosis).
Authors: H S Kim; D M Moreira; J Jayachandran; L Gerber; L L Bañez; R T Vollmer; A L Lark; M J Donovan; D Powell; F M Khan; S J Freedland Journal: Prostate Cancer Prostatic Dis Date: 2011-04-26 Impact factor: 5.554
Authors: Ayal A Aizer; Tyler J Wilhite; Ming-Hui Chen; Powell L Graham; Toni K Choueiri; Karen E Hoffman; Neil E Martin; Quoc-Dien Trinh; Jim C Hu; Paul L Nguyen Journal: Cancer Date: 2014-02-22 Impact factor: 6.860
Authors: Eric J Whitman; Mark Pomerantz; Yongmei Chen; Michael M Chamberlin; Bungo Furusato; Chunling Gao; Amina Ali; Lakshmi Ravindranath; Albert Dobi; Isabell A Sesterhenn; Isabell A Sestrehenn; David G McLeod; Shiv Srivastava; Matthew Freedman; Gyorgy Petrovics Journal: Cancer Epidemiol Biomarkers Prev Date: 2010-01 Impact factor: 4.254
Authors: Colette A Whitney; Lauren E Howard; Christopher L Amling; William J Aronson; Matthew R Cooperberg; Christopher J Kane; Martha K Terris; Stephen J Freedland Journal: Cancer Date: 2016-08-09 Impact factor: 6.860
Authors: Alexis R Gaines; Elizabeth L Turner; Patricia G Moorman; Stephen J Freedland; Christopher J Keto; Megan E McPhail; Delores J Grant; Adriana C Vidal; Cathrine Hoyo Journal: Cancer Causes Control Date: 2014-05-31 Impact factor: 2.506
Authors: Tiffany A Wallace; Robyn L Prueitt; Ming Yi; Tiffany M Howe; John W Gillespie; Harris G Yfantis; Robert M Stephens; Neil E Caporaso; Christopher A Loffredo; Stefan Ambs Journal: Cancer Res Date: 2008-02-01 Impact factor: 12.701
Authors: Daniel J George; Krishnan Ramaswamy; Ahong Huang; David Russell; Jack Mardekian; Neil M Schultz; Nora Janjan; Stephen J Freedland Journal: Prostate Cancer Prostatic Dis Date: 2021-11-03 Impact factor: 5.455