TY  - JOUR
A1  - Höh, Robert Benedikt
A1  - Würnschimmel, Christoph
A1  - Flammia, Rocco Simone
A1  - Horlemann, Benedikt
A1  - Sorce, Gabriele
A1  - Chierigo, Francesco
A1  - Tian, Zhe
A1  - Saad, Fred
A1  - Graefen, Markus
A1  - Gallucci, Michele
A1  - Briganti, Alberto
A1  - Terrone, Carlo
A1  - Shariat, Shahrokh F.
A1  - Tilki, Derya
A1  - Kluth, Luis
A1  - Mandel, Philipp
A1  - Chun, Felix
A1  - Karakiewicz, Pierre I.
T1  - Effect of chemotherapy in metastatic prostate cancer according to race/ethnicity groups
T2  - The prostate
N2  - Background: No North-American study tested the survival benefit of chemotherapy in de novo metastatic prostate cancer according to race/ethnicity. We addressed this void.
Methods: We identified de novo metastatic prostate cancer patients within the Surveillance, Epidemiology, and End Results database (2014–2015). Separate and specific Kaplan–Meier plots and Cox regression models tested for overall survival differences between chemotherapy-exposed versus chemotherapy-naïve patients in four race/ethnicity groups: Caucasian versus African-American versus Hispanic/Latino vs Asian. Race/ethnicity specific propensity score matching was applied. Here, additional landmark analysis was performed.
Results: Of 4232 de novo metastatic prostate cancer patients, 2690 (63.3%) were Caucasian versus 783 (18.5%) African-American versus 504 (11.8%) Hispanic/Latino versus 257 (6.1%) Asian. Chemotherapy rates were: 21.3% versus 20.8% versus 21.0% versus 20.2% for Caucasians versus African-Americans versus Hispanic/Latinos versus Asians, respectively. At 30 months of follow-up, overall survival rates between chemotherapy-exposed versus chemotherapy-naïve patients were 61.5 versus 53.2% (multivariable hazard ratio [mHR]: 0.76, 95 confidence interval [CI]: 0.63–0.92, p = 0.004) in Caucasians, 55.2 versus 51.6% (mHR: 0.76, 95 CI: 0.54–1.07, p = 0.11) in African-Americans, 62.8 versus 57.0% (mHR: 1.11, 95 CI: 0.73–1.71, p = 0.61) in Hispanic/Latinos and 77.7 versus 65.0% (mHR: 0.31, 95 CI: 0.11–0.89, p = 0.03) in Asians. Virtually the same findings were recorded after propensity score matching within each race/ethnicity group.
Conclusions: Caucasian and Asian de novo metastatic prostate cancer patients exhibit the greatest overall survival benefit from chemotherapy exposure. Conversely, no overall survival benefit from chemotherapy exposure could be identified in either African-Americans or Hispanic/Latinos. Further studies are clearly needed to address these race/ethnicity specific disparities.
KW  - chemotherapy
KW  - metastatic prostate cancer
KW  - race/ethnicity disparities
Y1  - 2022
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/75437
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-754371
SN  - 1097-0045
N1  - Open access funding enabled and organized by Projekt DEAL.
VL  - 82
IS  - 6
SP  - 676
EP  - 686
PB  - Wiley-Liss
CY  - New York, NY
ER  -