mCRPC: black men show higher survival odds in clinical trials

  • Halabi S & al.
  • J Clin Oncol
  • 21 Dec 2018

  • curated by Deepa Koli
  • Univadis Clinical Summaries
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Takeaway

  • Meta-analysis of 9 randomized trials suggests that black vs white men with metastatic castration-resistant prostate cancer (mCRPC) show 19% lower risk for mortality.

Why this matters

  • Limited data are available on racial disparities in men with advanced disease.

Study design

  • Meta-analysis of individual participant data from 9 randomized controlled trials (RCTs; including 8820 men with mCRPC, treated with docetaxel + prednisone alone or in combination with other therapies).
  • Funding: United States Army Medical Research.

Key results

  • Median follow-up time was 31 months.
  • Mortality rate was 68% vs 62% in black and white men, respectively.
  • 85% of patients were white and 6% were black.
  • Black patients were younger, had worse performance status, higher testosterone and PSA, and lower hemoglobin vs white patients.
  • Median OS was 21.0 months in black men and 21.2 months in white men.
  • Black men showed significantly lower risk for death:
    • Overall (pooled HR, 0.81; P<.001>
    • In the National Clinical Trials Network (NCTN) trials: pooled HR, 0.76 (95% CI, 0.66-0.88);
    • In patients treated with docetaxel + prednisone: pooled HR, 0.79 (95% CI, 0.67-0.93);
    • Patients assigned to docetaxel + prednisone in NCTN trials: pooled HR, 0.71 (95% CI, 0.58-0.87).

Limitations

  • Findings may not be generalizable.