Discussion
prostate cancer, aggressive disease
SECONDARY, METASTATIC PROSTATE CANCER, PROSTATE CANCER, PROSTATE
This secondary analysis of the SWOG 1216 trial found that ADT plus bicalutamide or ADT plus a novel androgen receptor pathway inhibitor (ARPI) elicited similar PFS, PSA response, and OS in Black and White patients with mCSPC, despite Black patients presenting with more aggressive disease features (younger age and higher baseline PSA level). In a race-stratified trial enrolling 100 patients with mCRPC (50 Black and 50 White patients), patients were treated with abiraterone acetate and prednisone as first-line therapy in addition to ongoing ADT.Historically, registration phase 3 clinical trials for metastatic prostate cancer have accrued disproportionately low numbers of Black patients, and this trend has worsened in the last 3 decades, especially in industry-sponsored trials.Our findings from the patient-level data from a prospective phase 3 trial validate the previous population-based research findings indicating that Black patients with advanced prostate cancer achieve comparable outcomes when health care access is equalized and treatment is standardized. A 2023 meta-analysis of more than 1 million patients with prostate cancer demonstrated that race was associated with prostate cancer-specific mortality and OS.