Sylvester Investigators Study Genetics of Prostate Cancer Patients to Understand What Drives Disparities

Researchers found that men with African ancestry are less likely to get comprehensive genetic profiling of their tumors earlier in treatment.

A photo of Brandon Mahal, M.D.
Brandon Mahal, M.D.

Researchers at Sylvester Comprehensive Cancer Center, part of the University of Miami Miller School of Medicine, studied the genomic profiles and treatment patterns of nearly 13,000 men with advanced prostate cancer to understand why men of African ancestry have the greatest global burden of the disease.

Their paper, published in The Lancet Digital Health, found it is unlikely that genomics is driving prostate cancer disparities between men of African versus European ancestry. Rather, the reasons for the disparities can be traced to the differences in care patients receive, according to the study’s senior author, Brandon Mahal, M.D., assistant professor of radiation oncology at Sylvester.

“I believe this is the largest and most representative genomic study of advanced prostate cancer in men of African and European ancestry,” Dr. Mahal said. “And the data clearly show no notable differences in genetic mutations that we would target for treatment between the ancestries, which suggests these mutations probably are not driving disparities in advanced prostate cancer.”

Dr. Mahal and the coauthors found that men of African ancestry — despite being at greater risk of developing advanced disease — are less likely to get comprehensive genetic profiling of their tumors earlier in treatment. That means that they don’t benefit as often as patients of European ancestry from testing that would help guide their treatment and improve outcomes. Instead, men of African ancestry tend to go through different types of treatment, not targeted to genetics, as their cancer progresses.

Men of African ancestry were also less likely than patients of European ancestry to go into prostate cancer clinical trials, which could expose them to newer, more effective treatments for advanced disease, according to Dr. Mahal.

“We’ve known for a couple of decades that prostate cancer disparities are some of the largest disparities we see across all cancer types. This research helps guide our efforts in terms of what is needed to address those disparities,” he said. “While this study looks at advanced prostate cancer and diminished the focus on genomics as the reason for disparities, there is still a reason to study the role of genomics in men’s risk of developing prostate cancer.”

Sylvester worked on the study in collaboration with researchers from Foundation Medicine, University of Michigan and Harvard Medical School.

Tags: cancer disparities, Dr. Brandon Mahal, genomics, prostate cancer, Sylvester Comprehensive Cancer Center, The Lancet Digital Health