Receipt of novel hormonal therapy for advanced prostate cancer varies with race

For Medicare beneficiaries with advanced prostate cancer (PCa), receipt of novel hormonal therapy (NHT) agents varies with race, according to a study published online Dec. 1 in JAMA Network Open.

Ting Martin Ma, M.D., Ph.D., from the University of Washington in Seattle, and colleagues examined racial and ethnic disparities in use of NHT in a cohort study involving men diagnosed with de novo advanced PCa with Medicare Part A, B, and D coverage between Jan. 1, 2011, and Dec. 31, 2017. A total of 3,748 men were included in the study (8, 7, 78, and 7 percent were Black, Hispanic, White, and other race and ethnicity, respectively).

The researchers found that 36 percent of the patients received one or more administration of NHT. The highest two-year NHT utilization rate was seen for White patients, followed by Hispanic patients, those with other race and ethnicity, and finally Black patients (27, 25, 23, and 20 percent, respectively). Compared with White patients, Black patients had significantly lower use of NHT, which persisted at five years (37 versus 44 percent) and beyond. The differences in NHT utilization were not significant for White versus Hispanic patients or those with other race or ethnicity. In patients with distant metastatic (M1) disease, trends of lower utilization among Black patients persisted (e.g., 51 versus 55 percent at five years). Black patients continued to have a significantly lower likelihood of NHT initiation after adjustment for patient, disease, and sociodemographic factors (adjusted subdistribution hazard ratio, 0.76).

“Future studies are needed to uncover underlying causes and to systematically address these issues for more equitable care,” the authors write.

Several authors disclosed ties to the pharmaceutical and medical device industries.

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