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
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.