PD34-03 RACIAL DISPARITY IN THE UTILIZATION OF NEW THERAPIES FOR ADVANCED PROSTATE CANCER

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You have accessJournal of UrologyProstate Cancer: Advanced (including Drug Therapy) III (PD34)1 Sep 2021PD34-03 RACIAL DISPARITY IN THE UTILIZATION OF NEW THERAPIES FOR ADVANCED PROSTATE CANCER Ali Mouzannar, Venkatasai S Atluri, Matthew Mason, Nachiketh Soodana Prakash, Deukwoo Kwon, Bruno Nahar, Sanoj Punnen, Mark Gonzalgo, Dipen Parekh, and Chad Ritch Ali MouzannarAli Mouzannar More articles by this author , Venkatasai S AtluriVenkatasai S Atluri More articles by this author , Matthew MasonMatthew Mason More articles by this author , Nachiketh Soodana PrakashNachiketh Soodana Prakash More articles by this author , Deukwoo KwonDeukwoo Kwon More articles by this author , Bruno NaharBruno Nahar More articles by this author , Sanoj PunnenSanoj Punnen More articles by this author , Mark GonzalgoMark Gonzalgo More articles by this author , Dipen ParekhDipen Parekh More articles by this author , and Chad RitchChad Ritch More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002038.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Black and Hispanic patients have a high burden of prostate cancer mortality and this may be related to barriers to treatment. In 2010, Sipuleucel-T immunotherapy was the first FDA approved agent (since docetaxel) for metastatic castration resistant prostate cancer (mCRPC). We sought to identify whether there was disparity in the utilization of immunotherapy in the treatment of black and hispanic patients with mCRPC. METHODS: Using the National Cancer Database, we identified patients between 2010-2015 with likely minimally/asymptomatic mCRPC: PSA 50-200ng/ml, Charlson 0-2, age <70, stage M1, treated with chemotherapy or immunotherapy. We analyzed annual trends for chemotherapy and immunotherapy use and compared utilization by demographic and clinical features. Multivariate analysis was performed to determine predictors of receiving immunotherapy vs chemotherapy. RESULTS: 1238 patients were included. Most were Non-hispanic white (63%), with private insurance (46.4%). Overall, there was increased utilization of immunotherapy from 2010 to 2013 (from 3.8% to 39.8%), followed by decrease to 10.9% in 2015 and, simultaneously, there was decreased utilization of chemotherapy from 2010 to 2013 (from 96.2% to 60.2%). The increased use of immunotherapy was predominantly in white patients and not seen in black and Hispanic patients (Figure 1). Relative to chemotherapy, immunotherapy was less likely to be used in a comprehensive community cancer program (OR 0.52, 95% CI 0.30 – 0.89), and patients with mid-high SES (OR 0.49, 95% CI 0.31 – 0.78). CONCLUSIONS: FDA approval of Sipuleucel-T in 2010 for mCRPC led to increased utilization of immunotherapy shortly thereafter, but this was mainly in white patients. Black and Hispanic patients proportionately did not exhibit increased utilization of this novel agent after 2010. Further study is necessary to help understand barriers to access to new treatment in mCRPC and eliminate the burden of disease in minority populations. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e583-e583 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ali Mouzannar More articles by this author Venkatasai S Atluri More articles by this author Matthew Mason More articles by this author Nachiketh Soodana Prakash More articles by this author Deukwoo Kwon More articles by this author Bruno Nahar More articles by this author Sanoj Punnen More articles by this author Mark Gonzalgo More articles by this author Dipen Parekh More articles by this author Chad Ritch More articles by this author Expand All Advertisement Loading ...