Black men have genetically different prostate cancer

Black men have different genomic mutations in prostate cancer than White or Asian men and this may underlie differences in incidence and prognosis and help direct treatment more effectively, according to a new study in the New England Journal of Medicine.

To better understand prostate cancer genomics in different groups, the researchers studied genomic sequences, focusing on mutations in 474 genes, from 2393 patients (1308 White, 133 Black, and 43 Asian) diagnosed with prostate cancer.

Results showed that Black men with metastatic prostate cancer were more likely than either White or Asian men to have tumour mutations in the androgen receptor, along with mutations in DNA-repair genes and genetic mutations that are targets for drug therapy. These findings could have implications for prognosis, response to therapy, and enrolment of minority populations in clinical trials, according to the authors.

‘Black men are much more likely to develop prostate cancer and more than twice as likely to die from it, and we need to understand why’: says Brandon Mahal, study author and assistant professor of radiation oncology at Sylvester Comprehensive Cancer Centre at the University of Miami Miller School of Medicine.

‘The studies we use to develop prognostic models and novel treatments based on genomics are highly Eurocentric, and there are few Black patients included in them. As a result, we risk developing precision prognostic tools and therapeutics that are really only designed for one population. This current trend could widen cancer disparities,’ he says.

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