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Investigators Question Effect of Race on Prostate Cancer Survival

Investigators Question Effect of Race on Prostate Cancer Survival

African-American patients with advanced prostate cancer survived slightly longer than white patients, according to a multi-institutional study led by Dana-Farber Cancer Institute researchers. The findings, which were reported at the 38th annual meeting of the American Society of Clinical Oncology, contradict the conventional notion that African-Americans with the disease die sooner.

The data were drawn from a pooled analysis of four randomized clinical trials in men with advanced prostate cancer that no longer responded to hormone treatments. On average, African-Americans in the trials survived for median of 15 months, whereas whites survived for a median of 14 months.

"This is evidence that African-Americans do just as well as whites when they’re treated within the context of a clinical trial," said Timothy D. Gilligan, md, a genitourinary oncologist at Dana-Farber. "This should discourage a pessimistic approach to prostate cancer in African-Americans in this setting."

Treatment Discrepancies

The finding, said Dr. Gilligan, challenges epidemiologic evidence, which has suggested that prostate cancer is more aggressive in African-Americans than in white men. Studies have shown that African-Americans typically are diagnosed with more advanced disease and have a higher mortality rate than whites. Dr. Gilligan said differences in treatment could explain the discrepancy.

The researchers from several institutions including Dana-Farber, Duke University, the University of Maryland, the University of California at San Francisco, and the University of Chicago pooled the outcomes of four trials of several different treatments for hormone-refractory prostate cancer. A total of 844 white men and 144 African-American men were enrolled in the studies. Their average age was 71 years, and 90% had metastases to other organs.

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