10 Apr Prostate Cancer in African American Men: High Mutation Frequency in Key Cancer Drivers
MedicalResearch.com Interview with:
Nicholas Mitsiades MD
Associate Professor of Medicine – Hematology and Oncology
Baylor College of Medicine
Oncologist at the Dan L Duncan Comprehensive Cancer Center
MedicalResearch.com: What is the background for this study?
Response: African American men have higher risk of developing prostate cancer and up to 2.2-times higher mortality rate from prostate cancer relative to men of other ancestries. This is the largest health disparity across all cancers in the US. Socioeconomic factors, especially access to healthcare, definitely contribute to this disparity. African American men are diagnosed with prostate cancer at a more advanced stage than other races, and this is unfortunately very common at Ben Taub Hospital, our safety-net hospital in the Houston area, where we serve large racial and ethnic minority populations and patients who lack commercial insurance.
MedicalResearch.com: What are the main findings?
Response: With the help of Tempus Labs, we offered state-of-the-art molecular testing called Next Generation Sequencing (NGS) of cancer tissues and circulating tumor DNA from the bloodstream to our advanced prostate cancer patients in our clinic at Ben Taub Hospital. We found, in our African American prostate cancer patients, a high frequency of several mutations in genes that drive cancer and increase the risk of death from the disease. A lot of these mutations are “actionable”, meaning that there are specific “targeted” therapies that we can offer to our patients based on these results.
MedicalResearch.com: What should readers take away from your report?
Response: Socioeconomic factors affect access to quality care for cancer patients. Access to healthcare is a major factor driving the health disparities in clinical outcomes seen in underserved minorities with prostate cancer. Our findings suggest that African American patients who present with very advanced prostate cancer to our center also have high rates of mutations in genes that are responsible for driving their cancer. Fortunately, there are specific treatments that can counteract the action of many of these mutations. However, the high cost of molecular testing can become an additional factor for disparity. Indeed, minority and uninsured patients were underrepresented in prior studies and in clinical trials that offer new therapeutic options to patients.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: Because most prostate cancer clinical studies have been performed in patients of European ancestry, the prevalence of actionable mutations in prostate cancer among minority patients (African Americans and others) and their responsiveness to targeted therapies remain poorly defined. There is an opportunity to address these disparities and offer better treatments to our patients based on the results of these tests.
The high mutation frequency in key PC drivers in AA patients at our safety net hospital can be attributed to underlying disease biology or the more advanced disease at presentation in our African American patients with socioeconomic factors delaying access to healthcare. Wider use of molecular testing is necessary to improve early access of underserved minority populations to novel targeted therapies and to biomarker-based Precision Oncology clinical trials.
Response: We would like to thank Tempus Labs for helping us provide outstanding care to uninsured and minority patients in the Houston area and we also thank the Prostate Cancer Foundation and the National Cancer Institute’s Cancer Moonshot Program for funding our work.
Citation: AACR 2021 abstract
Genomic characterization and monitoring molecular response to treatment in African American (AA) advanced prostate cancer (PC) patients (pts) via next-generation sequencing (NGS): Real-world experience in a safety net hospital Oncology clinic
Tamer Khashab, Salma Kaochar, Alexander D. Le, Samantha Cohen, Attiya B. Noor, Heidi Dowst, Neda Zarrin-Khameh, Michael A. Brooks, Guilherme Godoy, Maria A. Berezina, Anna E. Schwarzbach, Michael E. Scheurer, Martha P. Mims, Nicholas Mitsiades. Harris Health/Ben Taub Hospital/Baylor College of Medicine, Houston, TX, Baylor College of Medicine/Dan L. Duncan Comprehensive Cancer Center, Houston, TX, Tempus Labs, Chicago, IL, Harris Health/Ben Taub Hospital/Baylor College of Medicine/Dan L. Duncan Comprehensive Cancer Center, Houston, TX
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