Table 4: Representation of race/ethnicity in prostate cancer clinical trials using personalized therapy
In the last decade, there has been unprecedented progress in treatment options for patients with prostate cancer resulting in an ever-growing range of options. This raises the question of whether these are all the right options for individual patients to receive optimal therapy. Unfortunately, despite new advances in the field, the representation of African American men in these clinical trials to determine ethnic differences in clinical benefit remains inadequate92,93.
Examining the trials activated after 2016, we found that the inclusion of African American patients remains low (<5%) compared to that of European American patients in prostate cancer clinical trial for precision oncology, even reaching 0 recruitment of African American patients as in the trial NCT03093428 (Table 4). The future personalized treatment of PCa is based on these ongoing clinical trials, so the deficit in enrollment of African American participants might inhibit the generalization of the result to this subgroup of patients. Therefore, this existing disparity may have an impact on the potential benefit in survival, quality of life, and optimal therapies for African American patients.
Approximately 12% of men in the United States are African American92. Since AAM have twice the risk of developing PCa compared to EAM, a proposed representation could be 24% in clinical trials. However, the current average enrollment of AAM to prostate cancer clinical trials overall is only around 3%92,93. In only one of the trials that we analyzed, the number of AAM patients included did exceed that percentage, but this was not the case in the rest.