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Variation in Molecularly Defined Prostate Tumor Subtypes by Self-identified Race
Kevin H Kensler1, Shivanshu Awasthi2, Mohamed Alshalalfa3
1Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA.
European Urology Open Science
|May 31, 2022
Summary
Prostate cancer (PC) molecular subtypes show different frequencies between Black and White men, potentially contributing to mortality disparities. Further research is needed to understand the genomic risk differences by race.
Area of Science:
- Oncology
- Genomics
- Health Disparities
Background:
- Prostate cancer (PC) mortality disparities exist in the USA, driven by socioeconomic and healthcare factors.
- Tumor molecular heterogeneity may also play a role in higher PC mortality among Black men.
Purpose of the Study:
- To compare prostate cancer (PC) subtype frequency and genomic aggressiveness between Black and White patients.
- To investigate the role of molecular tumor characteristics in racial disparities in PC outcomes.
Main Methods:
- Five molecular subtype classifiers were applied to a cohort of 426 Black and 762 White PC patients from the Decipher Genomics Resource Information Database (GRID).
- Differences in subtype frequency and tumor genomic risk (Decipher score >0.6) were analyzed using chi-squared tests and multivariable logistic regression.
Main Results:
- Subtype frequencies differed significantly by race for four classifiers.
- Black men had higher frequencies of subtypes with SPOP mutations, SPINK1 overexpression, and neuroendocrine differentiation.
- White men had higher frequencies of ERG and ETS fusion-positive subtypes. The Tomlins ERG+ subtype was associated with higher genomic risk in Black men, but not White men.
Conclusions:
- The frequency of prostate cancer (PC) molecular subtypes varies by self-identified race.
- Further studies are necessary to determine if these observed differences in PC subtypes indicate varying tumor genomic risk of progression between racial groups.
