Variation in Molecularly Defined Prostate Tumor Subtypes by Self-identified Race

Kensler, Kevin H.; Awasthi, Shivanshu; Alshalalfa, Mohamed; Trock, Bruce J.; Freedland, Stephen J.; Freeman, Michael R.; You, Sungyong; Mahal, Brandon A.; Den, Robert B.; Dicker, Adam P.; Karnes, R. Jeffrey; Klein, Eric A.; Lal, Priti; Liu, Yang; Davicioni, Elai; Rayford, Walter; Yamoah, Kosj; Rebbeck, Timothy R.

doi:10.1016/j.euros.2022.03.014

Cited by 9 publications

(11 citation statements)

References 40 publications

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“…The classifiers used were: subtypes reflecting luminal or basal lineage; subtypes defined by the presence of ERG fusion, ETS fusion, SPINK1 overexpression; subtypes with early small cell or neuroendocrine differentiation; triple‐negative subtypes, for example, with luminal or basal lineage and ERG or ETS fusions; and Kamoun subtypes such as frequent ERG fusions with inactivation of p53 and PTEN. The association between subtypes and a genomic risk score differed by race suggests that certain subtypes may have a differential prognostic value between racial groups, independent of tumor clinicopathology 52 . Among AAM, the subtype with luminal lineage, high Gleason score, SPOP mutations, and ETS fusions exhibited a higher frequency.…”

Section: Genomics Of Tumor Biologymentioning

confidence: 99%

“…However, this association should not be generalized to the general population because the study did not sufficiently include AAM patients. 52 Another prospective study was conducted to determine the genomic risk of reclassification (GrR) using a clinically balanced cohort of African American men and non-African American men. GrR is the probability that a tumor, initially classified as low risk or favorable intermediate risk by conventional clinical risk classifiers, ultimately harbors genomic risk of metastasis when assessed by Decipher.…”

Section: Disparity In Genomic Applicationmentioning

confidence: 99%

“…In prostate cancer, various schemes have been developed to classify tumors into subtypes according to the expression of different genes. One study investigated the variation in the distribution and prognostic value of molecularly defined PCa transcriptomic subtype classifiers by race using Decipher 52 . Five classifiers that identify prostate tumor subtypes were studied and found that the subtypes differed in frequency between AAM and EAM.…”

Section: Genomics Of Tumor Biologymentioning

confidence: 99%

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Racial disparity in the genomics of precision oncology of prostate cancer

Le,

Rojas,

Fakunle

et al. 2023

Cancer Reports

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BackgroundSignificant racial disparities in prostate cancer incidence and mortality have been reported between African American Men (AAM), who are at increased risk for prostate cancer, and European American Men (EAM). In most of the studies carried out on prostate cancer, this population is underrepresented. With the advancement of genome‐wide association studies, several genetic predictor models of prostate cancer risk have been elaborated, as well as numerous studies that identify both germline and somatic mutations with clinical utility.Recent FindingsDespite significant advances, the AAM population continues to be underrepresented in genomic studies, which can limit generalizability and potentially widen disparities. Here we outline racial disparities in currently available genomic applications that are used to estimate the risk of individuals developing prostate cancer and to identify personalized oncology treatment strategies. While the incidence and mortality of prostate cancer are different between AAM and EAM, samples from AAM remain to be unrepresented in different studies.ConclusionThis disparity impacts the available genomic data on prostate cancer. As a result, the disparity can limit the predictive utility of the genomic applications and may lead to the widening of the existing disparities. More studies with substantially higher recruitment and engagement of African American patients are necessary to overcome this disparity.

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Section: Genomics Of Tumor Biologymentioning

confidence: 99%

Section: Disparity In Genomic Applicationmentioning

confidence: 99%

Section: Genomics Of Tumor Biologymentioning

confidence: 99%

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Racial disparity in the genomics of precision oncology of prostate cancer

Le,

Rojas,

Fakunle

et al. 2023

Cancer Reports

View full text Add to dashboard Cite

show abstract

“…Later studies associated with Decipher showed African American at high risk for an immune evasive and mesenchymal change subtypes, 24 but these findings are not necessarily reflected in the current validated platform. In addition, more recent reviews of the various arrays found that there were inconsistencies between races as well as prognostic risk of known molecular subtypes of prostate cancer 25 . Taken together, there may be a built-in bias as the result of validation with initial focus on non-African cohorts, and clinical decision-making should take these factors in strong consideration when testing high-risk African cohorts.…”

Section: Prostate Cancermentioning

confidence: 99%

Molecular Testing for Diagnostics, Prognostication, and Treatment Stratification in Cancers

2023

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Precision cancer care, for essentially all cancer types, now requires molecular diagnostics to assess mutations, chromosomal alterations, and gene expression to personalize treatments for individual patients. Advances in the diagnostics and treatment options have moved the field forward from fundamental discoveries beginning in the 1960s to the development of many targeted therapies that can be as specific as targeting a single-base-pair mutation. Herein is a brief historical perspective on cancer precision medicine with current diagnostic, prognostic, and treatment stratification guidance for early-and late-stage cancers.

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“…The association between subtypes and a genomic risk score differed by race, suggests that some subtypes may have differential prognostic value between racial groups, independent of tumor clinicopathology. 49 Another prospective study was conducted to determine the genomic risk of reclassification (GrR) between conventional clinical risk classifiers and the Decipher score, using a clinically balanced cohort of African-American men and non-African-American men. This study found that the majority of AAM men had a higher Decipher score than EAM patients, thus AAM were twice as likely to experience genomic risk of reclassification 50 .…”

Section: Disparity In Genomic Application?mentioning

confidence: 99%

Racial Disparity in Utilizing Genetic Testing for Personalized Care of Prostate Cancer

Rojas

Fakunle

et al. 2023

Preprint

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Significant racial disparities in prostate cancer incidence and mortality have been reported between African American Men (AAM) who are at increased risk for prostate cancer, and European American Men (EAM). In most of the studies carried out on prostate cancer, this population is underrepresented. With the advancement of genome-wide association studies (GWAS), several genetic predictor models of prostate cancer risk have been elaborated, as well as numerous studies that identify both germline and somatic mutations with clinical utility. Despite significant advances, the AAM population continues to be underrepresented in genomic studies, which can limit their generalizability and potentially widen disparities. Here we outline racial disparities in currently available genomic applications that are used to estimate the risk of individuals developing prostate cancer and to identify personalized oncology treatment strategies. While the incidence and mortality of prostate cancer are different between AAM and EAM. the biological features and differences of prostate tumors in AAM and EAM are still being described. Samples from AAM remain to be unrepresented in different studies. This disparity impacts the available genomic data on prostate cancer. As a result, the disparity can limit the predictive utility of the genomic applications that have been developed and may lead to widening disparities. More studies with substantially higher recruitment and engagement of African American patients are necessary to overcome this disparity.

show abstract

Variation in Molecularly Defined Prostate Tumor Subtypes by Self-identified Race

Cited by 9 publications

References 40 publications

Racial disparity in the genomics of precision oncology of prostate cancer

Racial disparity in the genomics of precision oncology of prostate cancer

Molecular Testing for Diagnostics, Prognostication, and Treatment Stratification in Cancers

Racial Disparity in Utilizing Genetic Testing for Personalized Care of Prostate Cancer

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