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Racial disparity in prostate cancer in the African American population with actionable ideas and novel immunotherapies

BACKGROUND: African Americans (AAs) in the United States are known to have a higher incidence and mortality for Prostate Cancer (PCa). The drivers of this epidemiological disparity are multifactorial, including socioeconomic factors leading to lifestyle and dietary issues, healthcare access problems...

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Autores principales: Dovey, Zachary S., Nair, Sujit S., Chakravarty, Dimple, Tewari, Ashutosh K.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8551995/
https://www.ncbi.nlm.nih.gov/pubmed/33599076
http://dx.doi.org/10.1002/cnr2.1340
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author Dovey, Zachary S.
Nair, Sujit S.
Chakravarty, Dimple
Tewari, Ashutosh K.
author_facet Dovey, Zachary S.
Nair, Sujit S.
Chakravarty, Dimple
Tewari, Ashutosh K.
author_sort Dovey, Zachary S.
collection PubMed
description BACKGROUND: African Americans (AAs) in the United States are known to have a higher incidence and mortality for Prostate Cancer (PCa). The drivers of this epidemiological disparity are multifactorial, including socioeconomic factors leading to lifestyle and dietary issues, healthcare access problems, and potentially tumor biology. RECENT FINDINGS: Although recent evidence suggests once access is equal, AA men have equal outcomes to Caucasian American (CA) men, differences in PCa incidence remain, and there is much to do to reverse disparities in mortality across the USA. A deeper understanding of these issues, both at the clinical and molecular level, can facilitate improved outcomes in the AA population. This review first discusses PCa oncogenesis in the context of its diverse hallmarks before benchmarking key molecular and genomic differences for PCa in AA men that have emerged in the recent literature. Studies have emphasized the importance of tumor microenvironment that contributes to both the unequal cancer burden and differences in clinical outcome between the races. Management of comorbidities like obesity, hypertension, and diabetes will provide an essential means of reducing prostate cancer incidence in AA men. Although requiring further AA specific research, several new treatment strategies such as immune checkpoint inhibitors used in combination PARP inhibitors and other emerging vaccines, including Sipuleucel‐T, have demonstrated some proven efficacy. CONCLUSION: Genomic profiling to integrate clinical and genomic data for diagnosis, prognosis, and treatment will allow physicians to plan a “Precision Medicine” approach to AA men. There is a pressing need for further research for risk stratification, which may allow early identification of AA men with higher risk disease based on their unique clinical, genomic, and immunological profiles, which can then be mapped to appropriate clinical trials. Treatment options are outlined, with a concise description of recent work in AA specific populations, detailing several targeted therapies, including immunotherapy. Also, a summary of current clinical trials involving AA men is presented, and it is important that policies are adopted to ensure that AA men are actively recruited. Although it is encouraging that many of these explore the lifestyle and educational initiatives and therapeutic interventions, there is much still work to be done to reduce incidence and mortality in AA men and equalize current racial disparities.
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spelling pubmed-85519952021-11-04 Racial disparity in prostate cancer in the African American population with actionable ideas and novel immunotherapies Dovey, Zachary S. Nair, Sujit S. Chakravarty, Dimple Tewari, Ashutosh K. Cancer Rep (Hoboken) Review BACKGROUND: African Americans (AAs) in the United States are known to have a higher incidence and mortality for Prostate Cancer (PCa). The drivers of this epidemiological disparity are multifactorial, including socioeconomic factors leading to lifestyle and dietary issues, healthcare access problems, and potentially tumor biology. RECENT FINDINGS: Although recent evidence suggests once access is equal, AA men have equal outcomes to Caucasian American (CA) men, differences in PCa incidence remain, and there is much to do to reverse disparities in mortality across the USA. A deeper understanding of these issues, both at the clinical and molecular level, can facilitate improved outcomes in the AA population. This review first discusses PCa oncogenesis in the context of its diverse hallmarks before benchmarking key molecular and genomic differences for PCa in AA men that have emerged in the recent literature. Studies have emphasized the importance of tumor microenvironment that contributes to both the unequal cancer burden and differences in clinical outcome between the races. Management of comorbidities like obesity, hypertension, and diabetes will provide an essential means of reducing prostate cancer incidence in AA men. Although requiring further AA specific research, several new treatment strategies such as immune checkpoint inhibitors used in combination PARP inhibitors and other emerging vaccines, including Sipuleucel‐T, have demonstrated some proven efficacy. CONCLUSION: Genomic profiling to integrate clinical and genomic data for diagnosis, prognosis, and treatment will allow physicians to plan a “Precision Medicine” approach to AA men. There is a pressing need for further research for risk stratification, which may allow early identification of AA men with higher risk disease based on their unique clinical, genomic, and immunological profiles, which can then be mapped to appropriate clinical trials. Treatment options are outlined, with a concise description of recent work in AA specific populations, detailing several targeted therapies, including immunotherapy. Also, a summary of current clinical trials involving AA men is presented, and it is important that policies are adopted to ensure that AA men are actively recruited. Although it is encouraging that many of these explore the lifestyle and educational initiatives and therapeutic interventions, there is much still work to be done to reduce incidence and mortality in AA men and equalize current racial disparities. John Wiley and Sons Inc. 2021-02-17 /pmc/articles/PMC8551995/ /pubmed/33599076 http://dx.doi.org/10.1002/cnr2.1340 Text en © 2021 The Authors. Cancer Reports published by Wiley Periodicals LLC. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review
Dovey, Zachary S.
Nair, Sujit S.
Chakravarty, Dimple
Tewari, Ashutosh K.
Racial disparity in prostate cancer in the African American population with actionable ideas and novel immunotherapies
title Racial disparity in prostate cancer in the African American population with actionable ideas and novel immunotherapies
title_full Racial disparity in prostate cancer in the African American population with actionable ideas and novel immunotherapies
title_fullStr Racial disparity in prostate cancer in the African American population with actionable ideas and novel immunotherapies
title_full_unstemmed Racial disparity in prostate cancer in the African American population with actionable ideas and novel immunotherapies
title_short Racial disparity in prostate cancer in the African American population with actionable ideas and novel immunotherapies
title_sort racial disparity in prostate cancer in the african american population with actionable ideas and novel immunotherapies
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8551995/
https://www.ncbi.nlm.nih.gov/pubmed/33599076
http://dx.doi.org/10.1002/cnr2.1340
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