Use of androgen suppression therapy may negatively impact survival in African American patients with favorable-risk prostate cancer, a study published in the journal Cancer has shown.1
African American men are more likely to present with comorbidities that could interact with androgen deprivation therapy (ADT) and reduce survival compared with non-African American men. Therefore, researchers sought to evaluate the effect that race had on all-cause mortality and other-cause mortality among patients definitively treated for favorable-risk prostate cancer.
For the study, investigators analyzed data from 7252 men with low-risk or favorable intermediate-risk prostate cancer who were treated between 1997 and 2013. Of those, 1501 received brachytherapy with neoadjuvant ADT and 5751 received brachytherapy alone for a median duration of 4 months.
Results showed that after a median follow-up of 8.04 years, 12.0% died, and of those, 5.52% were due to prostate cancer.
After adjusting for age at brachytherapy, year of brachytherapy, cardiometabolic comorbidity status, risk group, and ADT treatment propensity score, researchers observed a significant association between African American race and an increased risk of both all-cause mortality (hazard ratio [HR], 1.77; 95% CI, 1.06—2.94; P =.028) and other-cause mortality (HR, 1.86; 95% CI, 1.08-3.19; P =.024) among men who received ADT.
In contrast, there was no significant association between African American race and all-cause mortality (HR, 1.33; 95% CI, 0.93-1.91; P =.12) or other-cause mortality (HR, 1.39; 95% CI, 0.96-2.02; P =.08) among men who received only brachytherapy.
The findings ultimately suggest that clinicians should consider reserving the use of ADT for the treatment of higher risk prostate cancer in African American men.
1. Kovtun KA, Chen MH, Braccioforte MH, Moran BJ, D’Amico AV. Race and mortality risk after radiation therapy in men treated with or without androgen-suppression therapy for favorable-risk prostate cancer. Cancer. 2016 Aug 4. doi: 10.1002/cncr.30224. [Epub ahead of print]