TY - JOUR
T1 - Overall survival of black and white men with metastatic castration-resistant prostate cancer treated with docetaxel
AU - Halabi, Susan
AU - Dutta, Sandipan
AU - Tangen, Catherine M.
AU - Rosenthal, Mark
AU - Petrylak, Daniel P.
AU - Thompson, Ian M.
AU - Chi, Kim N.
AU - Araujo, John C.
AU - Logothetis, Christopher
AU - Quinn, David I.
AU - Fizazi, Karim
AU - Morris, Michael J.
AU - Eisenberger, Mario A.
AU - George, Daniel J.
AU - De Bono, Johann S.
AU - Higano, Celestia S.
AU - Tannock, Ian F.
AU - Small, Eric J.
AU - Kelly, William Kevin
N1 - Publisher Copyright:
© 2019 American Society of Clinical Oncology. All rights reserved.
PY - 2019/2/10
Y1 - 2019/2/10
N2 - PURPOSE Several studies have reported that among patients with localized prostate cancer, black men have a shorter overall survival (OS) time than white men, but few data exist for men with advanced prostate cancer. The primary goal of this analysis was to compare the OS in black and white men with metastatic castration-resistant prostate cancer (mCRPC) who were treated in phase III clinical trials with docetaxel plus prednisone (DP) or a DP-containing regimen. METHODS Individual participant data from 8,820 men with mCRPC randomly assigned in nine phase III trials to DP or a DP-containing regimen were combined. Race was based on self-report. The primary end point was OS. The Cox proportional hazards regression model was used to assess the prognostic importance of race (black v white) adjusted for established risk factors common across the trials (age, prostate-specific antigen, performance status, alkaline phosphatase, hemoglobin, and sites of metastases). RESULTS Of 8,820 men, 7,528 (85%) were white, 500 (6%) were black, 424 (5%) were Asian, and 368 (4%) were of unknown race. Black men were younger and had worse performance status, higher testosterone and prostate-specific antigen, and lower hemoglobin than white men. Despite these differences, the median OS was 21.0 months (95% CI, 19.4 to 22.5 months) versus 21.2 months (95% CI, 20.8 to 21.7 months) in black and white men, respectively. The pooled multivariable hazard ratio of 0.81 (95% CI, 0.72 to 0.91) demonstrates that overall, black men have a statistically significant decreased risk of death compared with white men (P, .001). CONCLUSION When adjusted for known prognostic factors, we observed a statistically significant increased OS in black versus white men with mCRPC who were enrolled in these clinical trials. The mechanism for these differences is not known.
AB - PURPOSE Several studies have reported that among patients with localized prostate cancer, black men have a shorter overall survival (OS) time than white men, but few data exist for men with advanced prostate cancer. The primary goal of this analysis was to compare the OS in black and white men with metastatic castration-resistant prostate cancer (mCRPC) who were treated in phase III clinical trials with docetaxel plus prednisone (DP) or a DP-containing regimen. METHODS Individual participant data from 8,820 men with mCRPC randomly assigned in nine phase III trials to DP or a DP-containing regimen were combined. Race was based on self-report. The primary end point was OS. The Cox proportional hazards regression model was used to assess the prognostic importance of race (black v white) adjusted for established risk factors common across the trials (age, prostate-specific antigen, performance status, alkaline phosphatase, hemoglobin, and sites of metastases). RESULTS Of 8,820 men, 7,528 (85%) were white, 500 (6%) were black, 424 (5%) were Asian, and 368 (4%) were of unknown race. Black men were younger and had worse performance status, higher testosterone and prostate-specific antigen, and lower hemoglobin than white men. Despite these differences, the median OS was 21.0 months (95% CI, 19.4 to 22.5 months) versus 21.2 months (95% CI, 20.8 to 21.7 months) in black and white men, respectively. The pooled multivariable hazard ratio of 0.81 (95% CI, 0.72 to 0.91) demonstrates that overall, black men have a statistically significant decreased risk of death compared with white men (P, .001). CONCLUSION When adjusted for known prognostic factors, we observed a statistically significant increased OS in black versus white men with mCRPC who were enrolled in these clinical trials. The mechanism for these differences is not known.
UR - http://www.scopus.com/inward/record.url?scp=85061152154&partnerID=8YFLogxK
U2 - 10.1200/JCO.18.01279
DO - 10.1200/JCO.18.01279
M3 - Article
C2 - 30576268
AN - SCOPUS:85061152154
SN - 0732-183X
VL - 37
SP - 403
EP - 410
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
IS - 5
ER -