A Prospective Study of Intraprostatic Inflammation, Focal Atrophy, and Progression to Lethal Prostate Cancer

Inflammation and focal atrophy are common features adjacent to prostate tumors. Limited evidence exists on whether these features have prognostic significance

Tackling Diversity in Prostate Cancer Clinical Trials: A Report From the Diversity Working Group of the IRONMAN Registry

Prostate cancer disproportionately affects racial and ethnic minority populations. Reasons for disparate outcomes among minority patients are multifaceted and complex, involving factors at the patient, provider, and system levels. Although advancements in our understanding of disease biology have led to novel therapeutics for men with advanced prostate cancer, including the introduction of biomarker-driven therapeutics, pivotal translational studies and clinical trials are underrepresented by minority populations. Despite attempts to bridge the disparities gap, there remains an unmet need to expand minority engagement and participation in clinical trials to better define the impact of therapy on efficacy outcomes, quality of life, and role of biomarkers in diverse patient populations. The IRONMAN registry (ClinicalTrials.gov identifier: NCT03151629 ), a global, prospective, population-based study, was borne from this unmet medical need to address persistent gaps in our knowledge of advanced prostate cancer. Through integrated collection of clinical outcomes, patient-reported outcomes, epidemiologic data, and biospecimens, IRONMAN has the goal of expanding our understanding of how and why prostate cancer outcomes differ by race and ethnicity. To this end, the Diversity Working Group of the IRONMAN registry has developed informed strategies for site selection, recruitment, engagement and retention, and trial design and eligibility criteria to ensure broad inclusion and needs awareness of minority participants. In concert with systematic strategies to tackle the complex levels of disparate care, our ultimate goal is to expand minority engagement in clinical research and bridge the disparities gap in prostate cancer care

Marital status, living arrangement, and survival among individuals with advanced prostate cancer in the International Registry for Men with Advanced Prostate Cancer

BACKGROUND: Studies have shown improved survival among individuals with cancer with higher levels of social support. Few studies have investigated social support and overall survival (OS) in individuals with advanced prostate cancer in an international cohort. We investigated the associations of marital status and living arrangements with OS among individuals with advanced prostate cancer in the International Registry for Men with Advanced Prostate Cancer (IRONMAN).METHODS: IRONMAN is enrolling participants diagnosed with advanced prostate cancer (metastatic hormone-sensitive prostate cancer, mHSPC; castration resistant prostate cancer, CRPC) from 16 countries. Participants in this analysis were recruited between July 2017 and January 2023. Adjusting for demographics and tumor characteristics, the associations were estimated using Cox regression and stratified by disease state (mHSPC, CRPC), age (&lt;70, 70+ years), and continent of enrollment (North America, Europe, Other).RESULTS: We included 2,119 participants with advanced prostate cancer, of whom 427 died during up to 5 years of follow-up (median 6 months). Two-thirds had mHSPC. Most were married/in a civil partnership (79%) and 6% were widowed. Very few married participants were living alone (1%), while most unmarried participants were living alone (70%). Married participants had better OS than unmarried participants (adjusted HR: 1.44; 95% CI: 1.02, 2.02). Widowed participants had the worst survival compared to married individuals (adjusted HR: 1.89; 95% CI: 1.22, 2.94).CONCLUSIONS: Among those with advanced prostate cancer, unmarried and widowed participants had worse OS compared to married participants.IMPACT: This research highlighted the importance of social support in OS within this vulnerable population.</p

Supplementary Table S9 from Pain and Its Association with Survival for Black and White Individuals with Advanced Prostate Cancer in the United States

Baseline bone pain scale Cox model results from sensitivity analysis for missing indicator values during MICE procedure</p

TABLE 4 from Pain and Its Association with Survival for Black and White Individuals with Advanced Prostate Cancer in the United States

Stratified analyses for the association between pain scales at enrollment and death, IRONMAN Registry 2017–2023</p

Supplementary Table S6 from Pain and Its Association with Survival for Black and White Individuals with Advanced Prostate Cancer in the United States

Baseline EORTC pain scale Cox model results from sensitivity analysis for missing indicator values during MICE procedure</p

FIGURE 2 from Pain and Its Association with Survival for Black and White Individuals with Advanced Prostate Cancer in the United States

Kaplan–Meier curves for overall survival by pain categories at study enrollment, IRONMAN Registry 2017–2023. A, Kaplan–Meier curve for the EORTC pain scale. B, Kaplan–Meier curve for the average pain scale. C, Kaplan–Meier curve for the worst pain scale. D, Kaplan–Meier curve for the bone pain scale.</p

Supplementary Table S7 from Pain and Its Association with Survival for Black and White Individuals with Advanced Prostate Cancer in the United States

Baseline average pain scale Cox model results from sensitivity analysis for missing indicator values during MICE procedure</p

Supplementary Figure S2 from Pain and Its Association with Survival for Black and White Individuals with Advanced Prostate Cancer in the United States

Selection of study participants exclusion flowchart</p

Supplementary Table S4 from Pain and Its Association with Survival for Black and White Individuals with Advanced Prostate Cancer in the United States

Reasons for being off-study by self-reported race</p