Accession Number : AD1002683


Title :   Novel Nomogram That Predicts Aggressive Disease and Treatment Failure Among African-American Men with Prostate Cancer


Descriptive Note : Technical Report,30 Sep 2013,29 Sep 2015


Corporate Author : Thomas Jefferson University Hospital Philadelphia United States


Personal Author(s) : Yamoah,Simeon J


Full Text : https://apps.dtic.mil/dtic/tr/fulltext/u2/1002683.pdf


Report Date : 01 Dec 2015


Pagination or Media Count : 32


Abstract : Prostate cancer (PCa) has greatest incidence and mortality among African American(AA) as compared to their European American (EA) counterparts in the US. This disparity has been attributed to a number of factors including access to care, screening patterns, and behavior. More recent data suggest that genetic/biologic factors may at least in part contribute to more aggressive disease in AA men. Using the SCORE database, we studied PCa outcomes in AA vs. EA men after radical prostatectomy. We showed that AA race was a predictor of worse biochemical failure in patients with pathologic Gleason score 6 or low-grade disease and favorable pathologic features (Yamoah et, al., 2014). Next, immunohistochemistry for 20 biomarkers was undertaken on the FFPE tumors of 45 EA and 55 AA men within the SCORE database. To date, 6 biomarkers have been analyzed including TMPRSS2-ERG, AMACR, PSMA, RB, c-Myc, and AR. We observed statistically significant differences in biomarker expression between EA vs AA for AMACR (p=0.004), c-myc (p=0.005), and AR (p=0.002). Furthermore, we demonstrated that there are substantial differences in the distribution of prostate tumor biomarkers between AA and EA men (Yamoah, et al. JCO 2015). The study, which included 154 AAM and 243 EAM samples pulled from the Decipher Genomics Resource Information Database (GRID),evaluated 20 validated biomarkers reported to be associated with PCa initiation and progression. Of 20 biomarkers examined, 6 showed statistically significant differential expression in AAM compared with EAM. These include ERG, AMACR, SPINK1, NKX3-1, GOLM1, and androgen receptor. Dys regulation of AMACR, ERG, FOXP1, and GSTP1 as well as loss-of-function mutations for tumor suppressors NKX3-1 and RB1 predicted risk of pathologic T3 disease in an ethnicity-dependent manner. Furthermore, A greater proportion of AA men than EA men had triple-negative (ERG-negative/ETS-negative/SPINK1-negative) disease (51% v 35%).


Descriptors :   african americans , prostate cancer , ethnic groups , radiation oncology , health care , statistical analysis , males


Distribution Statement : APPROVED FOR PUBLIC RELEASE