UC Irvine

Background: Africans Americans, low socioeconomic status (SES) and other minority patients have been observed to have higher rates of metastasis and prostate cancer specific mortality. There are several known genetic differences in prostate cancer between Whites and other minority patients which may adversely impact interpretations of validated genetic tests like the Decipher.

Methods: We conducted a cross-sectional analytical study of men with early stage prostate cancer. Mean Decipher scores, Decipher risk categories and gene expression signatures related to molecular pathways and treatment response were analyzed by race/ ethnicity and SES using one way of analysis of variance, linear and logistic regression.

Results: African Americans and other minority patients had non-significantly higher mean Decipher scores (p=0.227). There were non-significant differences in the distribution of Decipher risk categories by race/ethnicity (p=0.167). African American men had slightly lower ETS-related gene (ERG), lower E26 transformation-specific (ETS), higher serine protease inhibitor Kazal-type 1 (SPINK1) and higher Triple Negative molecular subtypes compared to Whites. African American men had slightly higher post-op radiation response (p=0.207), higher dasatinib sensitivity (p=0.002), but lower docetaxel sensitivity (p=0.007) and lower androgen receptor signaling (p=0.133) compared to Whites.

Conclusions: There were non-significant associations of Decipher scores with race or SES. However, African Americans and other minorities differed in the molecular subtypes and pharmacogenomics of docetaxel and dasatinib compared to Whites. Future efforts to create a precision medicine model for predicting outcomes and personalizing treatments to reduce prostate cancer disparities should include genetic differences in tumor by race/ ethnicity and treatment response.