Investigators Question Effect of Race on Prostate Cancer Survival

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

The data were drawn from a pooled analysis of four randomized clinical trialsin men with advanced prostate cancer that no longer responded to hormonetreatments. On average, African-Americans in the trials survived for median of15 months, whereas whites survived for a median of 14 months.

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

Treatment Discrepancies

The finding, said Dr. Gilligan, challenges epidemiologic evidence, which hassuggested that prostate cancer is more aggressive in African-Americans than inwhite men. Studies have shown that African-Americans typically are diagnosedwith 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, DukeUniversity, the University of Maryland, the University of California at SanFrancisco, and the University of Chicago pooled the outcomes of four trials ofseveral different treatments for hormone-refractory prostate cancer. A total of844 white men and 144 African-American men were enrolled in the studies. Theiraverage age was 71 years, and 90% had metastases to other organs.