PD21-07 RACIAL IMPACT (ASIAN VS. WHITE) ON THE PROGNOSIS OF PATIENTS WITH DE NOVO MCSPC: AN ANALYSIS ON LATITUDE, SEER AND NCDB

Abstract

You have accessJournal of UrologyCME1 Apr 2023PD21-07 RACIAL IMPACT (ASIAN VS. WHITE) ON THE PROGNOSIS OF PATIENTS WITH DE NOVO MCSPC: AN ANALYSIS ON LATITUDE, SEER AND NCDB XuDong Ni, Michael Luu, Weiwei Ma, Stephen Freedland, Timothy J. Daskivich, and Yao Zhu XuDong NiXuDong Ni More articles by this author , Michael LuuMichael Luu More articles by this author , Weiwei MaWeiwei Ma More articles by this author , Stephen FreedlandStephen Freedland More articles by this author , Timothy J. DaskivichTimothy J. Daskivich More articles by this author , and Yao ZhuYao Zhu More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003287.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Little is known about the impact of race (Asian or White) on the long-term survival outcomes of men with de novo mCSPC treated with different methods. Understanding racial disparities in survival is critical for accurate prognostic risk stratification and for informing the design of multiregional clinical trials. METHODS: This multiple-cohort study included individual patient-level data of men with de novo mCSPC from the following 3 cohorts: LATITUDE clinical trial data (LATITUDE [n = 1199]); Surveillance, Epidemiology, and End Results (SEER [n = 5496]); and the National Cancer Database (NCDB [n = 10366]). Key efficacy outcomes were overall survival (OS) in LATTITUDE and NCDB as well as OS and cancer-specific survival (CSS) in SEER. Kaplan-Meier analysis with propensity score matching (PSM) was used for survival analysis. Hazard ratios were calculated using a multivariate Cox proportional-hazard model. RESULTS: Across all three cohorts, Asian patients diagnosed with de novo mCSPC had better OS and CSS than White patients. In LATITUDE, median OS was significantly longer in Asian than in White men in the ADT+Abiraterone+Prednisone group (not reached vs. 43.8 months, HR0.47, 95% CI 0.28–0.77, P = 0.003 for cox analysis) as well as in the ADT+placebo group (57.6 months vs. 32.7 months, HR0.49, 95% CI 0.32–0.75, P = 0.001 for cox analysis). In SEER, among all patients diagnosed with de novo mCSPC, median OS was significantly longer in Asian than in White men (53 months vs. 42 months, HR0.76, 95% CI 0.68–0.85, p<0.001 for cox analysis). When analyses were restricted to patients who received chemotherapy, Asian men again had longer OS (67 months vs. 41 months, HR0.70 95% CI 0.51–0.95, p=0.02 for cox analysis). Using CSS data in SEER resulted in similar conclusions as OS. In NCDB, Asians also had longer OS than White men (whole cohort: 38 months vs. 26 months, HR0.73, 95%CI 0.63–0.84, P = 0.02 for cox analysis; ADT subgroup: 41 months vs. 26 months, HR0.75, 95% CI 0.63–0.89, p<0.001 for cox analysis; Chemotherapy subgroup: 34 months vs. 27 months, HR0.80, 95% CI 0.69–0.94, p=0.005 for cox analysis). CONCLUSIONS: Asian men had better OS and CSS than White men with mCSPC across different treatment regimens in all datasets examined and should be considered as an independent prognostic factor. This racial difference should also be considered when designing multiregional clinical trials. Further studies including biological analyses are needed to understand the etiology of the apparent survival advantage for Asian men. Source of Funding: NSFC 81972375, 81802528 © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e592 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information XuDong Ni More articles by this author Michael Luu More articles by this author Weiwei Ma More articles by this author Stephen Freedland More articles by this author Timothy J. Daskivich More articles by this author Yao Zhu More articles by this author Expand All Advertisement PDF downloadLoading ...