BACKGROUND: Docetaxel (DOC) and abiraterone (ABI) in the upfront setting have separately improved clinical outcomes for metastatic hormone-sensitive prostate cancer (mHSPC), but there are no studies comparing drug efficacies or the influence of racial disparities. MATERIALS AND METHODS: We performed a retrospective multicenter review from Winship Cancer Institute at Emory University and Georgia Cancer Center for Excellence at Grady Memorial Hospital (2014-2020) for patients with mHSPC treated with either upfront DOC or ABI. Outcomes evaluated were overall survival (OS), progression-free survival (PFS), and prostate-specific antigen complete response (PSA CR). RESULTS: A total of 168 patients were included, consisting of 92 (54.8%) Black patients and 76 (45.2%) non-Black patients (69 White and 7 Asian or Hispanic). Ninety-four (56%) received DOC and 74 (44%) received ABI. Median follow-up time was 22.8 months with data last reviewed June 2020. For OS, there was no significant difference between ABI versus DOC and Black versus non-Black patients. For PFS, DOC was associated with hazard ratio (HR) 1.7 compared with ABI for all patients based on univariate association and HR 2.27 compared with ABI for Black patients on multivariable analysis. For PSA CR, Black patients were less likely to have a CR (odds ratio [OR] = 0.27). CONCLUSION: ABI and DOC have similar OS with a trend toward better PFS for ABI in a cohort composed of 54% Black patients. Racial disparities were observed as prolonged PFS for Black patients treated with ABI, more so compared with all patients, and less PSA CR for Black patients. A prospective trial comparing available upfront therapies in a diverse racial population is needed to help guide clinical decision-making in the era of novel treatment options. IMPLICATIONS FOR PRACTICE: Overall survival is similar for abiraterone and docetaxel when used as upfront therapy in metastatic hormone-sensitive prostate cancer in a cohort composed of 54% Black patients. There is a trend towards improved progression-free survival for abiraterone in all patients and Black patients. Non-Black patients were more likely to achieve prostate-specific antigen (PSA) complete response regardless of upfront therapy.
BACKGROUND: Docetaxel (DOC) and abiraterone (ABI) in the upfront setting have separately improved clinical outcomes for metastatic hormone-sensitive prostate cancer (mHSPC), but there are no studies comparing drug efficacies or the influence of racial disparities. MATERIALS AND METHODS: We performed a retrospective multicenter review from Winship Cancer Institute at Emory University and Georgia Cancer Center for Excellence at Grady Memorial Hospital (2014-2020) for patients with mHSPC treated with either upfront DOC or ABI. Outcomes evaluated were overall survival (OS), progression-free survival (PFS), and prostate-specific antigen complete response (PSA CR). RESULTS: A total of 168 patients were included, consisting of 92 (54.8%) Black patients and 76 (45.2%) non-Black patients (69 White and 7 Asian or Hispanic). Ninety-four (56%) received DOC and 74 (44%) received ABI. Median follow-up time was 22.8 months with data last reviewed June 2020. For OS, there was no significant difference between ABI versus DOC and Black versus non-Black patients. For PFS, DOC was associated with hazard ratio (HR) 1.7 compared with ABI for all patients based on univariate association and HR 2.27 compared with ABI for Black patients on multivariable analysis. For PSA CR, Black patients were less likely to have a CR (odds ratio [OR] = 0.27). CONCLUSION: ABI and DOC have similar OS with a trend toward better PFS for ABI in a cohort composed of 54% Black patients. Racial disparities were observed as prolonged PFS for Black patients treated with ABI, more so compared with all patients, and less PSA CR for Black patients. A prospective trial comparing available upfront therapies in a diverse racial population is needed to help guide clinical decision-making in the era of novel treatment options. IMPLICATIONS FOR PRACTICE: Overall survival is similar for abiraterone and docetaxel when used as upfront therapy in metastatic hormone-sensitive prostate cancer in a cohort composed of 54% Black patients. There is a trend towards improved progression-free survival for abiraterone in all patients and Black patients. Non-Black patients were more likely to achieve prostate-specific antigen (PSA) complete response regardless of upfront therapy.
Authors: Oluwarotimi S Nettey; Austin J Walker; Mary Kate Keeter; Ashima Singal; Aishwarya Nugooru; Iman K Martin; Maria Ruden; Pooja Gogana; Michael A Dixon; Tijani Osuma; Courtney M P Hollowell; Roohollah Sharifi; Marin Sekosan; Ximing Yang; William J Catalona; Andre Kajdacsy-Balla; Virgilia Macias; Rick A Kittles; Adam B Murphy Journal: Urol Oncol Date: 2018-09-17 Impact factor: 3.498
Authors: Nicholas D James; Johann S de Bono; Melissa R Spears; Noel W Clarke; Malcolm D Mason; David P Dearnaley; Alastair W S Ritchie; Claire L Amos; Clare Gilson; Rob J Jones; David Matheson; Robin Millman; Gerhardt Attard; Simon Chowdhury; William R Cross; Silke Gillessen; Christopher C Parker; J Martin Russell; Dominik R Berthold; Chris Brawley; Fawzi Adab; San Aung; Alison J Birtle; Jo Bowen; Susannah Brock; Prabir Chakraborti; Catherine Ferguson; Joanna Gale; Emma Gray; Mohan Hingorani; Peter J Hoskin; Jason F Lester; Zafar I Malik; Fiona McKinna; Neil McPhail; Julian Money-Kyrle; Joe O'Sullivan; Omi Parikh; Andrew Protheroe; Angus Robinson; Narayanan N Srihari; Carys Thomas; John Wagstaff; James Wylie; Anjali Zarkar; Mahesh K B Parmar; Matthew R Sydes Journal: N Engl J Med Date: 2017-06-03 Impact factor: 91.245
Authors: Irene M Shui; Lorelei A Mucci; Peter Kraft; Rulla M Tamimi; Sara Lindstrom; Kathryn L Penney; Katharina Nimptsch; Bruce W Hollis; Natalie Dupre; Elizabeth A Platz; Meir J Stampfer; Edward Giovannucci Journal: J Natl Cancer Inst Date: 2012-04-12 Impact factor: 13.506
Authors: Jacqueline M Major; M Norman Oliver; Chyke A Doubeni; Albert R Hollenbeck; Barry I Graubard; Rashmi Sinha Journal: Cancer Causes Control Date: 2012-05-22 Impact factor: 2.506
Authors: Yusuke Koga; Hanbing Song; Zachary R Chalmers; Joshua D Campbell; Franklin W Huang; Justin Newberg; Eejung Kim; Jian Carrot-Zhang; Daphnee Piou; Paz Polak; Sarki A Abdulkadir; Elad Ziv; Matthew Meyerson; Garrett M Frampton Journal: Clin Cancer Res Date: 2020-07-10 Impact factor: 12.531
Authors: Nicholas D James; Matthew R Sydes; Noel W Clarke; Malcolm D Mason; David P Dearnaley; Melissa R Spears; Alastair W S Ritchie; Christopher C Parker; J Martin Russell; Gerhardt Attard; Johann de Bono; William Cross; Rob J Jones; George Thalmann; Claire Amos; David Matheson; Robin Millman; Mymoona Alzouebi; Sharon Beesley; Alison J Birtle; Susannah Brock; Richard Cathomas; Prabir Chakraborti; Simon Chowdhury; Audrey Cook; Tony Elliott; Joanna Gale; Stephanie Gibbs; John D Graham; John Hetherington; Robert Hughes; Robert Laing; Fiona McKinna; Duncan B McLaren; Joe M O'Sullivan; Omi Parikh; Clive Peedell; Andrew Protheroe; Angus J Robinson; Narayanan Srihari; Rajaguru Srinivasan; John Staffurth; Santhanam Sundar; Shaun Tolan; David Tsang; John Wagstaff; Mahesh K B Parmar Journal: Lancet Date: 2015-12-21 Impact factor: 79.321
Authors: Bi-Dar Wang; Qi Yang; Kristin Ceniccola; Fernando Bianco; Ramez Andrawis; Thomas Jarrett; Harold Frazier; Steven R Patierno; Norman H Lee Journal: Prostate Cancer Date: 2013-01-10