Retrospective cohort study of androgen deprivation therapy and outcomes after radiation therapy in Black versus White patients with prostate cancer

Prostate cancer in Black men compared with White men may be more sensitive to radiotherapy (RT) resulting in better outcomes in equal-access settings. The outcomes of androgen-deprivation therapy (ADT) versus RT alone in both groups are not well known. A USA-wide retrospective cohort study of 8716 Black and 17,826 White prostate cancer patients treated in the US Veterans Healthcare system between 2000 and 2020 found that Black patients receiving ADT after RT for prostate cancer, as compared to White patients, had a significantly lower risk of biochemical recurrence, but when not receiving ADT, had a greater risk of biochemical recurrence than White patients. Black versus White race was associated with lower risk of metastatic disease after biochemical recurrence. The authors conclude that differential response to ADT by race may contribute to the better outcomes among Black men undergoing RT for prostate cancer.