Outcomes better for Black men compared with White men in clinical trials of definitive radiotherapy for localized prostate cancer
WEDNESDAY, Jan. 12, 2022 (HealthDay News) — Among men with localized prostate cancer enrolled in clinical trials for definitive radiotherapy, Black men have better outcomes than White men, according to a review published online Dec. 29 in JAMA Network Open.
Ting Martin Ma, M.D., Ph.D., from University of California in Los Angeles, and colleagues conducted a systematic literature review and meta-analysis of data from randomized clinical trials of definitive radiotherapy for patients with localized prostate cancer. The selected studies enrolled a substantial number of Black men and reported on treatment-specific and overall outcomes.
Based on seven clinical trials (8,814 patients; 18.5 percent Black), the researchers found that at enrollment, Black men were more likely to have high-risk disease features. However, Black men were less likely to experience biochemical recurrence (subdistribution hazard ratio [sHR], 0.88; 95 percent confidence interval [CI], 0.58 to 0.91), distant metastasis (sHR, 0.72; 95 percent CI, 0.58 to 0.91), or prostate cancer-specific mortality (sHR, 0.72; 95 percent CI, 0.54 to 0.97). There were no significant differences noted in all-cause mortality (HR, 0.99; 95 percent CI, 0.92 to 1.07). Black race remained significantly associated with improved biochemical recurrence (adjusted sHR, 0.79; 95 percent CI, 0.72 to 0.88; P < 0.001), distant metastasis (adjusted sHR, 0.69; 95 percent CI, 0.55 to 0.87; P = 0.002), and prostate cancer-specific mortality (adjusted sHR, 0.68; 95 percent CI, 0.50 to 0.93; P = 0.01) in an adjusted analysis.
“The findings of this meta-analysis noted that Black men enrolled in randomized clinical trials presented with more aggressive disease features but had better treatment and disease-specific outcomes with radiotherapy-based therapy compared with White men, suggesting other important factors associated with outcome, such as access to care, as sources of disparity,” the authors write.
Several authors disclosed financial ties to pharmaceutical and medical-related companies.
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