The median time from initiation of ADT to chemotherapy was 25 months. Using multivariate analysis adjusting for age, year of diagnosis, income, education, Charlston comorbidity score and risk of prostate cancer, the African American cohort had a time from ADT to chemotherapy of 22.5 months compared to 27.5 months in Caucasian males (p=0.006). The authors suggest that a shorter progression to salvage chemotherapy is associated with worse survival outcomes, as that may represent more rapidly progressing disease.
Although there may be confounding factors and some selection biases that are challenging to account for, this data supports the findings that African American may have worse outcomes and more aggressive prostate cancer. It is interesting to see whether these findings are due to delay in diagnosis, access to care, resistance to treatment, or tumor biology itself. Additionally, as systemic treatments for prostate cancer continue to advance, future studies may be needed to see if any have greater benefit in the African American population.
Presented by: Maria Uloko, MD
Authors: Maria Uloko, Yunhua Fan, Stephanie Jarosek and Barinath Konety
Institution: University of Minnesota
Written By: David B. Cahn, DO, MBS, Fox Chase Cancer Center, Philadelphia, PA
at the 2017 AUA Annual Meeting - May 12 - 16, 2017 – Boston, Massachusetts, USA