New Study Identifies Genetic Differences in Veterans with Metastatic Prostate Cancer

In a comprehensive genomic profiling study focusing on non-Hispanic Black veterans with metastatic prostate cancer, researchers from Moffitt Cancer Center, University of Pennsylvania, University of California Los Angeles, and the Veterans Affairs (VA) National Precision Oncology Program have uncovered significant genetic variations in tumor biology between non-Hispanic Black and non-Hispanic white veterans. Notably, the study revealed that when both groups receive equal access to care, their survival outcomes are remarkably similar.

The findings, published in JAMA Network Open, stem from an analysis of data gathered from over 5,000 U.S. veterans diagnosed with metastatic prostate cancer who underwent next-generation sequencing from 2019 to 2023. The research indicated that non-Hispanic Black veterans exhibited higher rates of actionable immunotherapy targets, while non-Hispanic white veterans presented more frequent alterations in androgen receptor signaling and DNA repair pathways. Despite these biological disparities, survival rates were found to be comparable in the VA healthcare setting, which emphasizes equal access to treatment.

According to a senior researcher involved in the study, the results underscore the potential of precision oncology as a means to promote equitable cancer care. By employing genomic testing to tailor therapy options to patients based on their tumor characteristics rather than their racial background, more effective treatment pathways can be established.

Another co-author of the study highlighted its critical implications, stressing the need to overcome historical disparities in healthcare. By prioritizing access to genomic testing and tools, it is possible to significantly influence the treatment of prostate cancer across various demographic groups.

The research findings included several key observations:

• Non-Hispanic Black veterans showed a greater likelihood of having genomic alterations tied to potential benefits from immunotherapy, such as microsatellite instability.
• Non-Hispanic white veterans were found to have a higher prevalence of mutations in DNA repair genes and alterations in the androgen receptor axis, which may impact their responsiveness to hormonal therapies.
• Alterations in tumor suppressor genes were associated with poorer survival rates in both demographic groups.
• No biomarkers were identified that should be excluded from testing based on race.

The study's diverse cohort, which included 36% non-Hispanic Black veterans, reflects a significant improvement in representation compared to earlier genomic studies. The researchers emphasized the necessity of continuing to expand access to next-generation sequencing and ensuring that underrepresented populations are included in precision oncology research and clinical trials.

In conclusion, the study illustrates that by dismantling barriers to healthcare and applying precision medicine equitably, improvements in patient outcomes can be achieved for everyone, regardless of their background.