A study that was published recently online analyzed data from more than 5000 US veterans with metastatic prostate cancer who underwent next-generation sequencing between 2019 and 2023 and concluded that while non-Hispanic Black veterans had higher rates of actionable immunotherapy targets, non-Hispanic White veterans had more frequent alterations in androgen receptor signaling and DNA repair pathways. Despite these biological differences, survival outcomes were comparable in the equal-access Veterans Affairs (VA) setting.1
Their key findings, which were presented by researchers at Moffit Cancer Center, University of Pennsylvania, University of California Los Angeles, and the VA National Veterans Affairs National Precision Oncology Program, were:
- Non-Hispanic Black veterans were significantly more likely to have genomic alterations associated with immunotherapy benefit, such as microsatellite instability
- Non-Hispanic White veterans had higher rates of mutations in DNA repair genes and the androgen receptor axis, which may influence responsiveness to hormonal therapies
- Tumor suppressor gene alterations were linked to worse survival in both groups
- No biomarker was found that should be excluded from testing based on race
The study’s diverse cohort, consisting of 36% non-Hispanic Black veterans, represents a marked improvement in inclusion compared with previous genomic studies, according to a press release on the findings. Researchers emphasized the importance of ensuring that underrepresented groups are included in precision oncology research and clinical trials.
The research was supported by the National Cancer Institute (P30-CA076292), the Prostate Cancer Foundation (PCF22CHAL02), and the VA National Precision Oncology Program.
Reference
- Valle LF, Li J, Desai H, et al. Somatic tumor next-generation sequencing in US veterans with metastatic prostate cancer. JAMA Netw Open. 2025;8:e259119.
