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Prostate cancer precision medicine offers great potential, providing tailored approaches that maximize patient benefits. However, disparities remain, particularly among Black men, who may face unequal access and outcomes. 

  • Black men with metastatic castration-resistant prostate cancer show higher frequencies of certain genetic markers than White men.
  • Despite these actionable molecular markers, Black men are less likely to receive targeted therapy.
  • Clinicians may need to be aware of these disparities to offer equitable care.

Disparities in Genomic Alterations

According to a study published in JAMA Network Open, Black men with metastatic castration-resistant prostate cancer (mCRPC) had a higher frequency of mismatch repair deficiency (MMRD) or high microsatellite instability (MSI-H) than White men. Conversely, Black men displayed fewer PTEN alterations and TMPRSS2 translocations. These findings suggest that while the underlying genetic landscape of prostate cancer varies between Black and White patients, the clinical outcomes remain comparable.

Differences in Treatment Approaches

Even with the higher rates of actionable molecular data in Black men, there was a significantly lower likelihood for them to receive molecularly matched targeted therapy. Reasons for this disparity might include socio-economic factors, potential unconscious bias among healthcare practitioners, and the availability of resources at different treatment sites, all of which require further research to explore.

Forecasting the Impact on Prostate Cancer Treatment

The study’s findings recommend an increase in awareness among clinicians about the disparities in precision medicine for prostate cancer. With an increased awareness of these differences, healthcare providers can better advocate for their patients and tailor treatments based on the patient’s genomic profile.

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In addition, clinicians can consider not only the genomic data but also the broader socioeconomic and systemic factors that can influence treatment choices. Offering equitable care means being proactive to ensure patients, regardless of their racial or ethnic background, have access to the best available treatments for their unique genetic profile. As precision medicine continues to evolve, healthcare providers can stay updated and strive for equality in their own practices.


Hwang, C., Henderson, N. C., Chu, S., Holland, B., Cackowski, F. C., Pilling, A. B., Jang, A., Rothstein, S. E., Labriola, M., Park, J. J., Ghose, A., Bilen, M. A., Mustafa, S. M., Kilari, D., Pierro, M., Thapa, B., Tripathi, A., Garje, R., Ravindra, A., . . . Barata, P. C. (2023). Biomarker-Directed therapy in Black and white men with Metastatic Castration-Resistant prostate Cancer. JAMA Network Open, 6(9), e2334208. https://doi.org/10.1001/jamanetworkopen.2023.34208