Race-Related Germline Genetic Variation and Response to Secondary Hormonal Therapy in Metastatic Castration-Resistant Prostate Cancer
Abstract
African Americans make up roughly 14% of the U.S. population, and yet they account for over 20% of prostate cancer cases and 30% of deaths from this disease. Prostate cancer is worse in African American men, even when we take into account differences in socioeconomic and lifestyle factors. Understanding why is important. There are biological factors that we inherit as part of our race, and these factors can affect how aggressive a cancer grows and spreads through the body. We have identified some biological factors in prostate cancer from African American men that might cause it to grow or spread more. Given that African American men more frequently have prostate cancer that grows and spreads more quickly, it is critical to determine how well treatments for prostate cancer work for African American patients. The way we evaluate cancer treatments in the United States is by conducting clinical trials in which patients volunteer to test if treatment with a new cancer drug will work against their cancer. Sadly, many clinical trials have very few African American participants and, therefore, for many cancer drugs, we do not know how African American patients respond to such treatments compared to the general population. To begin to evaluate how one of the recently approved drugs for prostate cancer works in African American patients, we conducted a clinical trial specifically designed to enroll African American and white patients in equal numbers. We completed this clinical trial and found that African American patients actually responded better to this drug than white patients. During this clinical trial, patients also volunteered to give blood for testing in the laboratory. Through our analysis of these blood samples, we were able to begin to identify biological differences that seem to align with better response to the drug in African American patients, including differences in DNA and metabolism. The work proposed in this application will focus on confirming whether these biological differences do in fact cause African American patients to respond better to the drug. First, we will test directly in the laboratory whether these biological differences make prostate cancer cells respond better to the drug. In addition, we are conducting a second clinical trial using a similar drug treatment and, again, this trial is enrolling African American and white patients in equal numbers. Patients in this trial are again volunteering to give blood for testing in the laboratory. We will use these samples to confirm whether, once again, these same biological differences align with better response to the drug in African American patients. Third, since this drug, treatment is similar, but not the same, we will also identify any additional biological differences that seem to align with better response to this drug in African American patients. This work will identify biological factors that cause African American men with prostate cancer to respond better to two recently developed drugs. Such knowledge will help inform which African American patients will benefit most from receiving these drugs and prioritize when such patients should receive these drugs to get the most benefit from them. Ultimately, this strategy has the potential to mitigate the suffering and death from prostate cancer in the African American community.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Nov 19, 2019
- Source ID
- W81XWH1910458
Entities
People
- Daniel J George
Organizations
- Duke University
- United States Army