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Multi-institutional Analysis of the Clinical and Genomic Characteristics of Black Patients with Metastatic Hormone-Sensitive Prostate Cancer

BACKGROUND: The outcomes of metastatic hormone-sensitive prostate cancer (mHSPC) have significantly improved through treatment intensification, yet Black representation in those studies is suboptimal. METHODS: A multi-institutional, retrospective analysis of Black men with mHSPC was conducted, focus...

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Autores principales: Freeman, Meredith N, Jang, Albert, Zhu, Jason, Sanati, Farhad, Nandagopal, Lakshminarayanan, Ravindranathan, Deepak, Desai, Arpita, Phone, Audrey, Nussenzveig, Roberto, Jaeger, Ellen, Caputo, Sydney A, Koshkin, Vadim S, Swami, Umang, Basu, Arnab, Bilen, Mehmet A, Agarwal, Neeraj, Sartor, Oliver, Burgess, Earle F, Barata, Pedro C
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8914485/
https://www.ncbi.nlm.nih.gov/pubmed/35274720
http://dx.doi.org/10.1093/oncolo/oyab057
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author Freeman, Meredith N
Jang, Albert
Zhu, Jason
Sanati, Farhad
Nandagopal, Lakshminarayanan
Ravindranathan, Deepak
Desai, Arpita
Phone, Audrey
Nussenzveig, Roberto
Jaeger, Ellen
Caputo, Sydney A
Koshkin, Vadim S
Swami, Umang
Basu, Arnab
Bilen, Mehmet A
Agarwal, Neeraj
Sartor, Oliver
Burgess, Earle F
Barata, Pedro C
author_facet Freeman, Meredith N
Jang, Albert
Zhu, Jason
Sanati, Farhad
Nandagopal, Lakshminarayanan
Ravindranathan, Deepak
Desai, Arpita
Phone, Audrey
Nussenzveig, Roberto
Jaeger, Ellen
Caputo, Sydney A
Koshkin, Vadim S
Swami, Umang
Basu, Arnab
Bilen, Mehmet A
Agarwal, Neeraj
Sartor, Oliver
Burgess, Earle F
Barata, Pedro C
author_sort Freeman, Meredith N
collection PubMed
description BACKGROUND: The outcomes of metastatic hormone-sensitive prostate cancer (mHSPC) have significantly improved through treatment intensification, yet Black representation in those studies is suboptimal. METHODS: A multi-institutional, retrospective analysis of Black men with mHSPC was conducted, focusing on baseline demographics, treatment patterns, genomic profiles, clinical outcomes including prostate-specific antigen response, time to castrate-resistant prostate cancer (CRPC), and subsequent treatments. RESULTS: A total of 107 patients, median age 64 years, 62% with de novo metastases at diagnosis and 64% with high-volume disease, were included. Twenty-nine patients (27%) were treated with androgen deprivation therapy (ADT) with and without first generation anti-androgens, while 20%, 38% and 5% received chemotherapy, abiraterone, and enzalutamide, respectively. At time of data cut-off, 57 (54%) patients had developed CRPC, with a median time to CRPC of 25.4 months (95% CI 20.3-30.4). The median time to CRPC was 46.3 months (18.9-73.7) and 23.4 months (18.6-28.2) for patients who received ADT with or without first-generation anti-androgens and treatment intensification, respectively. The 2-year survival rate was 93.3%, and estimated median overall survival of was 74.9 months (95% CI, 68.7-81.0). Most patients (90%) underwent germline testing; the most frequent known alterations were found within the DNA repair group of genes. Somatic testing revealed pathogenic alterations of interest, notably TP53 (24%) and CDK12 (12%). CONCLUSION: In our cohort, Black men with mHSPC presented with a high proportion of de novo metastases and high-volume disease. Treatment outcomes were very favorable with ADT-based regimens. The genomic landscape suggests different molecular profile relative to White patients with potential therapeutic implications.
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spelling pubmed-89144852022-03-11 Multi-institutional Analysis of the Clinical and Genomic Characteristics of Black Patients with Metastatic Hormone-Sensitive Prostate Cancer Freeman, Meredith N Jang, Albert Zhu, Jason Sanati, Farhad Nandagopal, Lakshminarayanan Ravindranathan, Deepak Desai, Arpita Phone, Audrey Nussenzveig, Roberto Jaeger, Ellen Caputo, Sydney A Koshkin, Vadim S Swami, Umang Basu, Arnab Bilen, Mehmet A Agarwal, Neeraj Sartor, Oliver Burgess, Earle F Barata, Pedro C Oncologist Genitourinary Cancer BACKGROUND: The outcomes of metastatic hormone-sensitive prostate cancer (mHSPC) have significantly improved through treatment intensification, yet Black representation in those studies is suboptimal. METHODS: A multi-institutional, retrospective analysis of Black men with mHSPC was conducted, focusing on baseline demographics, treatment patterns, genomic profiles, clinical outcomes including prostate-specific antigen response, time to castrate-resistant prostate cancer (CRPC), and subsequent treatments. RESULTS: A total of 107 patients, median age 64 years, 62% with de novo metastases at diagnosis and 64% with high-volume disease, were included. Twenty-nine patients (27%) were treated with androgen deprivation therapy (ADT) with and without first generation anti-androgens, while 20%, 38% and 5% received chemotherapy, abiraterone, and enzalutamide, respectively. At time of data cut-off, 57 (54%) patients had developed CRPC, with a median time to CRPC of 25.4 months (95% CI 20.3-30.4). The median time to CRPC was 46.3 months (18.9-73.7) and 23.4 months (18.6-28.2) for patients who received ADT with or without first-generation anti-androgens and treatment intensification, respectively. The 2-year survival rate was 93.3%, and estimated median overall survival of was 74.9 months (95% CI, 68.7-81.0). Most patients (90%) underwent germline testing; the most frequent known alterations were found within the DNA repair group of genes. Somatic testing revealed pathogenic alterations of interest, notably TP53 (24%) and CDK12 (12%). CONCLUSION: In our cohort, Black men with mHSPC presented with a high proportion of de novo metastases and high-volume disease. Treatment outcomes were very favorable with ADT-based regimens. The genomic landscape suggests different molecular profile relative to White patients with potential therapeutic implications. Oxford University Press 2022-02-24 /pmc/articles/PMC8914485/ /pubmed/35274720 http://dx.doi.org/10.1093/oncolo/oyab057 Text en © The Author(s) 2022. Published by Oxford University Press. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Genitourinary Cancer
Freeman, Meredith N
Jang, Albert
Zhu, Jason
Sanati, Farhad
Nandagopal, Lakshminarayanan
Ravindranathan, Deepak
Desai, Arpita
Phone, Audrey
Nussenzveig, Roberto
Jaeger, Ellen
Caputo, Sydney A
Koshkin, Vadim S
Swami, Umang
Basu, Arnab
Bilen, Mehmet A
Agarwal, Neeraj
Sartor, Oliver
Burgess, Earle F
Barata, Pedro C
Multi-institutional Analysis of the Clinical and Genomic Characteristics of Black Patients with Metastatic Hormone-Sensitive Prostate Cancer
title Multi-institutional Analysis of the Clinical and Genomic Characteristics of Black Patients with Metastatic Hormone-Sensitive Prostate Cancer
title_full Multi-institutional Analysis of the Clinical and Genomic Characteristics of Black Patients with Metastatic Hormone-Sensitive Prostate Cancer
title_fullStr Multi-institutional Analysis of the Clinical and Genomic Characteristics of Black Patients with Metastatic Hormone-Sensitive Prostate Cancer
title_full_unstemmed Multi-institutional Analysis of the Clinical and Genomic Characteristics of Black Patients with Metastatic Hormone-Sensitive Prostate Cancer
title_short Multi-institutional Analysis of the Clinical and Genomic Characteristics of Black Patients with Metastatic Hormone-Sensitive Prostate Cancer
title_sort multi-institutional analysis of the clinical and genomic characteristics of black patients with metastatic hormone-sensitive prostate cancer
topic Genitourinary Cancer
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8914485/
https://www.ncbi.nlm.nih.gov/pubmed/35274720
http://dx.doi.org/10.1093/oncolo/oyab057
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