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Quality of life in the year after new diagnosis with advanced prostate cancer for Black and White individuals living in the US

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Abstract

Purpose

To assess differences in baseline and longitudinal quality of life among Black and White individuals in the US with advanced prostate cancer.

Methods

Secondary analysis of data from the International Registry for Men with Advanced Prostate Cancer (IRONMAN) including US participants newly diagnosed with advanced prostate cancer and identifying their race as Black or White from 2017 to 2023. Participants completed the EORTC QLQ-C30 Quality of Life (QoL) Survey at study enrollment and every 3 months thereafter for up to 1 year of follow-up reporting 15 scale scores ranging from 0 to 100 (higher functioning and lower symptom scores represent better quality of life). Linear mixed effects models with race and month of questionnaire completion were fit for each scale, and model coefficients were used to assess differences in baseline and longitudinal QoL by race.

Results

Eight hundred and seventy-nine participants were included (20% identifying as Black) at 38 US sites. Compared to White participants at baseline, Black participants had worse constipation (mean 6.3 percentage points higher; 95% CI 2.9–9.8), financial insecurity (5.7 (1.4–10.0)), and pain (5.1 (0.9–9.3)). QoL decreased over time similarly by race; most notably, role functioning decreased by 0.7 percentage points (95% CI −0.8, −0.5) per month.

Conclusion

There are notable differences in quality of life at new diagnosis of advanced prostate cancer for Black and White individuals, and quality of life declines similarly in the first year for both groups. Interventions that address specific aspects of quality of life in these patients could meaningfully improve the overall survivorship experience.

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Data availability

Raw data was provided by the Prostate Cancer Clinical Trials Consortium (PCCTC), and investigators are not approved to share raw data with others directly. Researchers interested in working with the IRONMAN data can submit a study proposal to PCCTC to obtain access.

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Acknowledgements

The authors would like to thank the participants enrolled in the IRONMAN registry, without whom this research would not be possible. We would also like to thank the IRONMAN investigators and study teams at the 38 sites included in this study for their efforts to enroll and support the IRONMAN participants.

Funding

E.M. Rencsok was supported by the National Cancer Institute [F30CA264965] and the National Institute of General Medical Sciences [T32GM007753, T32GM144273]; L.A. Mucci is a Prostate Cancer Foundation Young Investigator; D.J. George and L.A. Mucci are recipients of the Prostate Cancer Foundation Challenge Award; the International Registry for Men with Advanced Prostate Cancer (IRONMAN, NCT 03151629) is funded by Amgen, AstraZeneca, Astellas, Bayer, Janssen, Merck, and Sanofi. This project is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of General Medical Sciences or the National Institutes of Health.

Author information

Author notes

  1. Sebastien Haneuse and Lorelei A. Mucci have contributed equally and share senior co-authorship.

Authors and Affiliations

  1. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA

    Emily M. Rencsok & Lorelei A. Mucci

  2. Harvard-MIT Division of Health Sciences and Technology, Harvard Medical School, Boston, MA, USA

    Emily M. Rencsok

  3. Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA

    Natalie Slopen

  4. Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Karen Autio, Dana Rathkopf & Philip W. Kantoff

  5. Dana-Farber Cancer Institute, Boston, MA, USA

    Alicia Morgans & Mark Pomerantz

  6. Durham, NC, USA

    Lawrence McSwain

  7. Section of Hematology and Oncology, Tulane University School of Medicine, New Orleans, LA, USA

    Pedro Barata

  8. University Hospitals Seidman Cancer Center, Cleveland, OH, USA

    Pedro Barata

  9. Division of Medical Oncology, University of Washington, Seattle, WA, USA

    Heather H. Cheng

  10. Fred Hutchinson Cancer Center, Seattle, WA, USA

    Heather H. Cheng

  11. University of Virginia Cancer Center, Charlottesville, VA, USA

    Robert Dreicer

  12. Karmanos Cancer Institute, Detroit, MI, USA

    Elisabeth Heath

  13. Department of Oncology, University of California San Diego Moores Cancer Center, La Jolla, CA, USA

    Rana R. McKay

  14. Division of Hematology and Medical Oncology, Weill Cornell Medical Center, New York, NY, USA

    Scott Tagawa

  15. Department of Medicine, Division of Oncology, University of North Carolina School of Medicine, Chapel Hill, NC, USA

    Young E. Whang

  16. Fox Chase Cancer Center, Philadelphia, PA, USA

    Camille Ragin

  17. African-Caribbean Cancer Consortium, Philadelphia, PA, USA

    Camille Ragin

  18. Mayo Clinic Comprehensive Cancer Center, Jacksonville, FL, USA

    Folakemi T. Odedina

  19. Prostate Cancer Transatlantic Consortium (CaPTC), Jacksonville, FL, USA

    Folakemi T. Odedina

  20. Duke Cancer Institute, Durham, NC, USA

    Daniel J. George

  21. Convergent Therapeutics, Cambridge, MA, USA

    Philip W. Kantoff

  22. Prostate Cancer Clinical Trials Consortium (PCCTC), New York, NY, USA

    Jacob Vinson

  23. Movember Foundation, Melbourne, Australia

    Paul Villanti

  24. Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA

    Sebastien Haneuse

Authors
  1. Emily M. Rencsok
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  2. Natalie Slopen
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  3. Karen Autio
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  4. Alicia Morgans
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  5. Lawrence McSwain
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  6. Pedro Barata
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  7. Heather H. Cheng
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  8. Robert Dreicer
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  9. Elisabeth Heath
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  12. Dana Rathkopf
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  13. Scott Tagawa
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  14. Young E. Whang
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  15. Camille Ragin
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  16. Folakemi T. Odedina
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  17. Daniel J. George
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  18. Philip W. Kantoff
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  19. Jacob Vinson
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  20. Paul Villanti
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  21. Sebastien Haneuse
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  22. Lorelei A. Mucci
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The IRONMAN Registry

Corresponding author

Correspondence to Emily M. Rencsok.

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AM consults for Astellas, AstraZeneca, AAA, Bayer, Dendreon, Exelixis, Janssen, Pfizer, Myovant, Novartis, Myriad Genetics, Lantheus, Telix, Sanofi and receives research funding from Astellas, Bayer, Pfizer, Myovant, Sanofi, SeaGen. PB consults for Astellas, AVEO Oncology, Bayer, BMS, Dendreon, Eisai, Exelixis, Janssen, EMD Serono, Guardant Health, Pfizer, Seattle Genetics; receives research support from AstraZeneca, AVEO Oncology, BlueEarth Diagnostics, Merck, Natera, Caris Life Sciences; and is part of the speaker’s bureau for Bayer, Caris Life Sciences, Pfizer, Myovant, Natera. HHC receives institutional research support from Astellas, Clovis Oncology, Color Genomics, Janssen, Medivation, Promontory Therapeutics, Sanofi; consults for AstraZeneca; and receives royalties from UpToDate. RD consults for Astellas, Aveo, Bayer, Exelixis, Gilead, Hinova, Janssen, Merck, Pfizer, Sanofi Genzyme, Tavanta. EH consults for Astellas Pharma, Bayer, Janssen Research & Development LLC, Sanofi; receives paid travel from Astellas Pharma, Caris Life Sciences, Sanofi, Seattle Genetics; receives research funding from Astellas Pharma, Arvinas, AstraZeneca, BioXcel Therapeutics, Bristol-Myers Squibb, Calibr, Calithera Biosciences Inc, Caris Life Sciences, Corcept Therapeutics, Corvis Pharmaceuticals, Daiichi Sankyo Inc, Eisai Inc, Exelixis, Five Prime Therapeutics, Fortis Therapeutics, GlaxoSmithKline, Gilead Sciences Inc, Harpoon Therapeutics, Hoffman-La Roche, Infinity Pharmaceuticals, iTeos Therapeutics, Janssen Research & Development LLC, Merck Sharp & Dohme Merck, Mirati Therapeutics, Modra Pharmaceuticals, Oncolys BioPharma, Peloton Therapeutics Inc, Pfizer, Pharmacyclics LLC, POINT Biopharma, Seattle Genetics; and receives honoraria from Bayer, Sanofi, and Seattle Genetics. RRM consults for Aveo, AstraZeneca, Bayer, BMS, Calithera, Caris, Dendreon, Exelixis, JNJ, Lilly, Myovant, Merck, Novartis, Pfizer, Sanofi, Sorrento Therapeutics, Telix, Tempus; receives research funding from Bayer, Tempus, AstraZeneca, Oncternal Therapeutics. DR receives institutional research support from Janssen, Bayer, AstraZeneca, Genentech, BMS/Celgene, Taiho, Promontory; serves on the board for Janssen, AstraZeneca, Bayer, Myovant, Genentech, Promontory, BMS/Celgene. ST receives institutional research support from Sanofi, Medivation, Astellas, Janssen, Amgen, Progenics, Dendreon, Lilly, Genentech, Newlink, BMS, Inovio, AstraZeneca, Immunomedics, Aveo, Rexahn, Atlab, Boehringer Ingelheim, Millennium, Bayer, Merck, Abbvie, Karyopharm, Endocyte, Clovis, Seattle Genetics, Novartis, Gilead, POINT Biopharma, Ambrx; consults for Sanofi, Medivation/Astellas, Dendreon, Janssen, Genentech, Bayer, Endocyte, Eisai, Immunomedics, Karyopharm, Abbvie, Tolmar, Seattle Genetics, Amgen, Clovis, QED, Pfizer, AAA/Novartis, Clarity, Genomic Health, POINT Biopharma, Blue Earth, AIkido Pharma, Telix Pharma, Convergent Therapeutics, EMD Serono, Myovant, Merck, Atlab Pharma, Phosplatin Therapeutics, Amgen, Ambrx; has a patent on biomarkers for sacituzumab govitecan therapy (Immunomedics / Gilead / Weill Cornell). YW receives institutional research support from Arvinas, Clovis Oncology; consults for Janssen. PWK has investment interest in Convergent Therapeutics, Context Therapeutics LLC, ESSA Pharma; serves on the board for Convergent Therapeutics, Context Therapeutics, ESSA Pharma; consults for ImmunisAI, PrognomIQ. LAM serves on the board of Convergent Therapeutics; consults for Bayer; receives institutional research support from Janssen, AstraZeneca. All other authors report no conflicts of interest.

Ethical approval

The original project underwent ethics review and was approved by the Institutional Review Board of the Harvard T. H. Chan School of Public Health. Informed consent was obtained from all participants in the IRONMAN Registry and included consent to access their personal demographic and health information in addition to use of their de-identified data for analyses using IRONMAN Registry data. The authors received access to de-identified IRONMAN registry data for the analyses presented here through an arrangement between the Harvard T. H. Chan School of Public Health and the Prostate Cancer Clinical Trials Consortium (the Clinical and Data Coordination Center for the IRONMAN Registry).

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Rencsok, E.M., Slopen, N., Autio, K. et al. Quality of life in the year after new diagnosis with advanced prostate cancer for Black and White individuals living in the US. Qual Life Res 32, 3209–3221 (2023). https://doi.org/10.1007/s11136-023-03468-0

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