The following is a summary of “Race and Treatment Outcomes in Patients With Metastatic Castration-Sensitive Prostate Cancer: A Secondary Analysis of the SWOG 1216 Phase 3 Trial,” published in the August 2023 issue of Oncology by Sayegh et al.

Black patients with prostate cancer have worse outcomes than white patients, but equitable access to care in clinical trials may improve survival for both groups. Researchers performed a prospective study to examine race-based survival outcomes of metastatic castration-sensitive prostate cancer (mCSPC) patients in a phase 3 trial with many Black participants.

This study conducted a secondary analysis of patient-level data from a phase 3 trial on metastatic castration-sensitive prostate cancer. Patients were randomized to receive either orteronel or bicalutamide, and the main outcome measure was Overall Survival (OS), with Progression-Free Survival (PFS) as a secondary endpoint.

The study involved 1,313 participants, 10% identified as Black (135) and 82% as White (1,077), with equal distribution between groups. Black patients were younger (median age 65.8 [IQR 60-70] years) vs 68.4 [62.5-74.1] years; P = .001) and had a higher baseline prostate-specific antigen response rate than White patients (median 54.7 [IQR 19.8-222.0] vs 26.7 [IQR 9.2-96.0] ng/mL; P < .001). After a median follow-up of 4.9 years, both groups showed similar median PFS (Black: 2.3 years [95% CI 1.8-1.4]; White: 2.9 years [95% CI 2.5-3.3; P = .71]) and OS (Black: 5.5 years [95% CI 4.8-NR]; White: 6.3 years [95% CI 5.7-NR; P = .65]). Multivariable analysis confirmed no significant difference in PFS and OS after adjusting for prognostic factors, and no interaction between race and treatment was observed.

The study concluded that Black and White patients had similar outcomes with androgen deprivation therapy, suggesting that equitable access to care may reduce historical differences.

Source: pubmed.ncbi.nlm.nih.gov/37526936/