Variation in Molecularly Defined Prostate Tumor Subtypes by Self-identified Race.

Socioeconomic and health care utilization factors are major drivers of prostate cancer (PC) mortality disparities in the USA; however, tumor molecular heterogeneity may also contribute to the higher mortality among Black men.

To compare differences in PC subtype frequency and genomic aggressiveness by self-identified race.

Five molecular subtype classifiers were applied for 426 Black and 762 White PC patients in the Decipher Genomics Resource Information Database (GRID).

Differences in subtype frequency and tumor genomic risk (Decipher score >0.6) by race were evaluated using χ2 tests and multivariable-adjusted logistic regression models.

Subtype frequencies differed by race for four classifiers. Subtypes characterized by the presence of SPOP mutations, SPINK1 overexpression, and neuroendocrine differentiation were more common among Black men. ERG and ETS fusion-positive subtypes were more frequent among White men, with no clear differences for subtypes reflecting luminal versus basal lineage. The hypothesized low-risk Kamoun S2 subtype was associated with a lower Decipher score among White men only (p = 0.01 for heterogeneity), while the aggressive You PCS1 subtype was associated with a higher Decipher score among White men only (p = 0.001 for heterogeneity). The Tomlins ERG+ subtype was associated with a higher Decipher score relative to all other subtypes among Black men, with no association among White men (p = 0.007 for heterogeneity).

The frequency of PC molecular subtypes differed by self-identified race. Additional studies are required to evaluate whether our observations suggest differences in the tumor genomic risk of progression by self-identified race.

We studied five classifiers that identify subtypes of prostate tumors and found that subtypes differed in frequency between Black and White patients. Further research is warranted to evaluate how differences in tumor subtypes may contribute to disparities in prostate cancer mortality.

European urology open science. 2022 Apr 26*** epublish ***

Kevin H Kensler, Shivanshu Awasthi, Mohamed Alshalalfa, Bruce J Trock, Stephen J Freedland, Michael R Freeman, Sungyong You, Brandon A Mahal, Robert B Den, Adam P Dicker, R Jeffrey Karnes, Eric A Klein, Priti Lal, Yang Liu, Elai Davicioni, Walter Rayford, Kosj Yamoah, Timothy R Rebbeck

Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA., Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA., Department of Radiation Oncology, Miller School of Medicine, University of Miami, Miami, FL, USA., Johns Hopkins Brady Urological Institute, Baltimore, MD, USA., Division of Urology, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA., Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, PA, USA., Department of Urology, Mayo Clinic, Rochester, MN, USA., Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA., Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA., Decipher Biosciences, Inc., San Diego, CA, USA., The Urology Group, LLC, Memphis, TN, USA., Division of Population Sciences, Dana-Farber Cancer Institute, Boston, MA, USA.

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