Large study of black men with prostate cancer to look beyond genetics

Researchers at Keck School of Medicine of USC are leading a $26.5 million effort to conduct the first large-scale study of black men with prostate cancer.

“Not only are African-American men twice as likely to develop prostate cancer, but they are more likely to have an aggressive, more lethal form of the disease, and we do not know why,” Christopher Haiman, ScD, professor of preventive medicine at Keck School of Medicine, said in a press release. “It is a health disparity that needs to be addressed. Considerable money, time and effort have gone into studies in men of European ancestry; it is time for a large-scale effort devoted to men of African ancestry.”

The collaborative effort — funded by grants from NCI, the National Institute on Minority Health and Health Disparities, and the Prostate Cancer Foundation — will include investigators from several other institutions and entities: Rutgers Cancer Institute of New Jersey, New Jersey State Cancer Registry, New Jersey Department of Health, Public Health Institute, Emory University, Johns Hopkins University, LSU Health New Orleans, Baylor College of Medicine, Moffitt Cancer Center, Barbara Ann Karmanos Cancer Institute/Wayne State University and University of California, San Francisco.

HemOnc Today spoke with Haiman about the rationale for the study, how the research will be conducted, what he and colleagues hope to learn, and the potential implications of their findings.

Question: Can you describe the rationale for this study?

Answer: The rationale is to gain insight into the genetic nature of aggressive prostate cancer — specifically how genetic variants interact with social and environmental factors that may contribute to prostate cancer. There has been a longstanding disparity in disease incidence, as well as aggressive disease and mortality, among men of African ancestry compared with other populations. Strong evidence suggests there is a genetic basis for some of the disparities, based upon some of the work that we have done in the African Ancestry Prostate Cancer Consortium. We are now going beyond genetics.

Q: How will the study be conducted?

A: We plan to recruit 10,000 black men recently diagnosed with prostate cancer. They will be recruited primarily through cancer registries in California, Detroit, New Jersey, Georgia, Texas, Louisiana and Florida. The men will be asked to respond to a survey, provide a saliva sample, and grant permission for researchers to access their prostate cancer biopsy or tumor tissue. The samples will be used to identify genetic markers for prostate cancer and tumor characteristics, with a special emphasis on aggressive prostate cancer.

Q: What is the timeline for results?

A: This is a 5-year study. However, we hope to follow these men prospectively after 5 years to study other endpoints, including recurrence and mortality.

Q: What do you and colleagues hope to learn from the study?

A: We are trying to understand racial and ethnic disparities and find out how social stress and genetic factors work together to influence risk for aggressive disease. We hope that the information we glean from this study and future studies will help us to identify strategies to prevent prostate cancer and improve outcomes for those with prostate cancer.

Q: Is there anything else that you would like to mention?

A: Enrolling 10,000 black men with prostate cancer will be a considerable challenge. We want to encourage black men to participate, as it is only through their participation in this study that we will be able to make progress on understanding the factors that are contributing to the disease in this population. Recruitment for the study will begin in early 2019. For more information about the study and how to participate, visit www.respondstudy.org. – by Jennifer Southall

For more information:

Christopher Haiman, ScD, can be reached at Keck School of Medicine of USC, 1975 Zonal Ave., Los Angeles, CA 90033; email: haiman@usc.edu.

Disclosure: Haiman reports no relevant financial disclosures.