Retrospective cohort study of somatic tumor next-generation sequencing in US veterans with metastatic prostate cancer

Guidelines recommend next-generation sequencing (NGS) of tumors in patients diagnosed with metastatic prostate cancer (mPCa) to identify potential actionable alterations. Non-Hispanic Black (NHB) men are poorly represented in precision oncology cohorts, so that differences in alterations frequencies between NHB and NHW men are poorly characterized. A retrospective cohort study of 5015 US veterans with mPCa identified alteration frequencies in NHB and NHW men. NHB race and ethnicity was associated with higher odds of genomic alterations in SPOP and immunotherapy targets, including high microsatellite instability status, whereas NHW race and ethnicity was associated with higher odds of genomic alterations in the AKT/PI3K pathway, androgen receptor axis, and tumor suppressor genes. TP53 alterations were similarly associated with poor survival in both NHB and NHW men. The authors conclude that these findings reinforce the utility of genomic testing for identifying candidates for precision oncology treatments, irrespective of race and ethnicity.