Androgen-Deprivation Therapy May Increase Mortality in African American Men With Favorable-Risk Prostate Cancer

Key Points

  • African American men who were treated with androgen-deprivation therapy had a 77% higher risk of death not due to prostate cancer, compared to non–African American men.
  • The exposure to androgen-deprivation therapy needed to cause this risk averaged only 4 months, according to researchers.

In a retrospective study analyzing patients' medical records, researchers at Brigham and Women's Hospital (BWH) found that race significantly affected longevity by increasing the likelihood of death after receiving androgen-deprivation therapy. These findings were published by Kovtun et al in Cancer.

Konstantin Kovtun, MD, a resident at BWH; Anthony D'Amico, MD, PhD, Chief of Genitourinary Radiation Oncology at BWH; and colleagues analyzed the medical records of over 7,000 men from the Chicago Prostate Cancer Center who had low-risk or favorable intermediate–risk prostate cancer, 20% of whom were treated with androgen-deprivation therapy in order to reduce the size of their prostate to make them eligible for brachytherapy.

Study Findings

The team found that African American men treated with androgen-deprivation therapy had a 77% higher risk of death not due to prostate cancer, compared to non–African American men.

“When African American men were exposed to an average of only 4 months of hormone therapy, primarily used to make the prostate small enough for brachytherapy, they suffered from higher mortality rates due to causes other than prostate cancer than non–African American men,” Dr. Kovtun explained. “This leads us to believe that there may be something intrinsic to the biology of African American men that predisposes them to this increased risk of death, and that this deserves further study.”

This team of BWH researchers is the first to observe the negative effects of androgen-deprivation therapy in the context of racial differences, specifically comparing African American men to non–African American men after adjusting for age, comorbidities such as heart disease, and established prostate cancer prognostic factors.

“These results show that careful consideration should be taken by physicians when recommending treatment for low-risk or favorable intermediate–risk prostate cancer, a cancer that very few men die of even without treatment,” Dr. D'Amico said. “There is no evidence that [androgen-deprivation therapy] followed by brachytherapy increases the chance of cure in comparison to other treatments, such an external-beam radiation therapy alone, in these men with favorable-risk prostate cancer. The subsequent risks of [androgen-deprivation therapy], specifically linked to African American men, deserve further study.”

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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