Does race make a difference in how long men with advanced prostate cancer live when treated with abiraterone or enzalutamide?

This is a summary of a research article originally published in Prostate Cancer and Prostatic Diseases. There were few Black men in the clinical trials that led to the approval of the medications abiraterone and enzalutamide. Abiraterone and enzalutamide are the two most commonly used drugs to treat men with advanced prostate cancer that has progressed on traditional hormonal therapy. This type of prostate cancer is called metastatic castration-resistant prostate cancer (mCRPC). Overall, Black men have a higher likelihood of dying from prostate cancer than White men. Researchers wanted to find out if Black men and White men with mCRPC benefitted differently when treated with either abiraterone or enzalutamide. To do this, researchers looked at medical information from the Veterans Health Administration (VHA). The VHA is a large healthcare system for veterans in the US where everyone has equal access to treatment. This was a real-world study, not a clinical trial. This means that researchers looked at what happened when men received the treatments prescribed by their healthcare practitioners.

After accounting for differences in the men's age and health conditions, researchers found that, on average, Black men with mCRPC actually lived 8 months longer than White men with mCRPC.

This real-world, US study of men with mCRPC treated with abiraterone or enzalutamide found that Black men lived longer than White men. All men in this study had equal access to healthcare and were treated with either abiraterone or enzalutamide. More research is needed to understand the reasons for this. Understanding these reasons could guide treatment to help men with mCRPC live longer.

Future oncology (London, England). 2022 Oct 13 [Epub ahead of print]

Daniel J George, Krishnan Ramaswamy, Ahong Huang, David Russell, Neil M Schultz, Nora Janjan, Stephen J Freedland

Duke Cancer Institute, Duke University School of Medicine, Durham, North Carolina, USA., Pfizer Inc, New York, New York, USA., Formerly of STATinMED Research, Plano, Texas, USA., Astellas Pharma, Inc, Northbrook, Illinois, USA., Division of Urology, Department of Surgery, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.