Clinical outcomes in men of diverse ethnic backgrounds with metastatic castration-resistant prostate cancer.

Background: We have shown previously in multivariable analysis that black men had 19% lower risk of death than white men with metastatic castration-resistant prostate cancer (mCRPC) treated with a docetaxel and prednisone (DP)-based regimen. The primary goal of this analysis was to compare progression-free survival (PFS), biochemical PFS, ≥50% decline in prostate-specific antigen (PSA) from baseline and objective response rate (ORR) in white, black and Asian men with mCRPC treated with a DP-based regimen.
Patients and Methods: Individual patient data from 8820 mCRPC men randomized on nine phase III trials to a DP-containing regimen were combined. Race used in the analysis was based on self-report. End points were PFS, biochemical PSA, ≥50% decline in PSA from baseline and ORR. The proportional hazards and the logistic regression models were employed to assess the prognostic importance of race in predicting outcomes adjusting for established prognostic factors.
Results: Of 8820 patients, 7528 (85%) were white, 500 (6%) were black, 424 were Asian (5%) and 368 (4%) had race unspecified. Median PFS were 8.3 [95% confidence interval (CI) 8.2-8.5], 8.2 (95% CI 7.4-8.8) and 8.3 (95% CI 7.6-8.8) months in white, black and Asian men, respectively. Median PSA PFS were 9.9 (95% CI 9.7-10.4), 8.5 (95% CI 8.0-10.3) and 11.1 (95% CI 9.9-12.5) months in white, black and Asian men, respectively.
Conclusions: We observed no differences in clinical outcomes by race and ethnic groups in men with mCRPC enrolled on these phase III clinical trials with DP.
Competing Interests: Disclosure SH reports other from Bayer, Eisai and Ferring; outside the submitted work. DPP consultant fees: Ada Cap (Advanced Accelerator Applications), Amgen, Astellas, AstraZeneca, Bayer, Bicycle Therapeutics (added January 2020), Boehringer Ingelheim, Bristol Myer Squibb, Clovis, Eli Lilly, Exelixis, Incyte, Janssen, Pfizer, Pharmacyclics, Roche Laboratories, Seattle Genetics, Urogen. Grant support: Ada Cap (Advanced Accelerator Applications), Astellas, AstraZeneca, Bayer, Bristol Myers Squibb, Clovis, Eli Lilly, Endocyte, Genentech, Innocrin, MedImmune, Merck, Novartis, Pfizer, Progenics, Roche Laboratories, Sanofi Aventis, Seattle Genetics; Ownership interest/investment: Bellicum, Tyme (sold October 2019). KC reports grants and personal fees from Janssen, Astellas, Sanofi, Bayer, Roche and AstraZeneca, outside the submitted work. JDB has served on advisory boards and received fees from many companies including AstraZeneca, Astellas, Bayer, Boehringer Ingelheim, Cellcentric, Daiichi, Genentech/Roche, Genmab, GlaxoSmithKline, Janssen, Merck Serono, Merck Sharp & Dohme, Menarini/Silicon Biosystems, Orion, Pfizer, Qiagen, Sanofi Aventis, Sierra Oncology, Taiho, Vertex Pharmaceuticals. He is an employee of the Institute of Cancer Research, which have received funding or other support for his research work from AstraZeneca, Astellas, Bayer, Cellcentric, Daiichi, Genentech, Genmab, GlaxoSmithKline, Janssen, Merck Serono, MSD, Menarini/Silicon Biosystems, Orion, Sanofi Aventis, Sierra Oncology, Taiho, Pfizer, Vertex, and which has a commercial interest in abiraterone, poly (ADP-ribose) polymerase inhibition in DNA repair defective cancers and PI3K/AKT pathway inhibitors (no personal income). He was named as an inventor, with no financial interest, for patent 8,822,438. He has been the CI/PI of many industry sponsored clinical trials. JDB is a National Institute for Health Research (NIHR) Senior Investigator. The views expressed in this article are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. CL reports honoraria and consultant fees from Sanofi, Bayer, Janssen, Astellas Pharma. In addition, he reports research grants from Sanofi, Bayer, Janssen, Astellas Pharma and Pfizer. DIQ reports compensated consultant: Astellas, Bayer, BMS, Advanced Accelerator Applications, Roche/Genentech, Janssen, Merck, Novartis, Pfizer. Travel: Astellas, Bayer, Bristol Myers Squibb, Genentech, Merck, Pfizer. Research to institution: Bayer, Bristol Myers Squibb, Roche/Genentech, Merck, Pfizer. KF: participation to advisory boards/honorarium for: Astellas, Bayer, Curevac, Janssen, MSD, Orion, Sanofi. MJM reports consultant fees from Bayer, Endocyte, Advanced Accelerator Applications, Blue Earth Diagnostics, Tokai Pharmaceuticals, Tolmar Pharmaceuticals, ORIC Pharmaceutical. Travel: Bayer, Endocyte. In addition he reports research funding to the institution from Bayer, Sanofi, Endocyte, Progenics, Corcept Therapeutics, Roche/Genentech. CSH reports other from Aptevo, Aragon Pharma, Astellas, AstraZeneca, Bayer, Clovis, Dendreon, eFFECTOR Therapeutics, Emergent, Ferring, Genentech, Hoffman-La Roche, Medivation and Pfizer. She reports personal fees from Aptevo, Asana, Astellas, Bayer, Blue Earth Diagnostics, Pharma, fees from Clovis, Dendreon, Endocyte, Ferring, Hinova, Janssen, Merck, Myriad, Orion, Pfizer, Tolmar, Carrick Therapeutics, Novartis, outside the submitted work. IFT reports other from Sanofi, during the conduct of the study; other from Janssen, Bayer, Roche-Genentech, outside the submitted work. EJS reports consultant fees and honoraria from Fortis, Janssen Oncology, Beigene, Tolero Pharmaceuticals. Travel from Janssen. In addition, he reports research grants to institution from Janssen, Merck. The remaining authors have declared no conflicts of interest.
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