SAN FRANCISCO—Black men with metastatic castration-resistant prostate cancer (mCRPC) may be receiving radium-223 treatment later in their disease course than their nonblack counterparts, but they have a lower risk of death, according to study findings presented at the 2019 Genitourinary Cancers Symposium.

In a study comparing 87 black men and 231 nonblack men with mCRPC receiving care in the Veterans Affairs health system, a team led by Stephen J. Freedland, MD, of the Cedars-Sinai Medical Center in Los Angeles and the Durham VA Medical Center in Durham, North Carolina, found that black men were significantly more likely to have received docetaxel prior to radium-223 (77% vs 55%). They also had significantly higher mean PSA and alkaline phosphatase levels at the start of radium-223 treatment than nonblack men (159.9 vs 90.2 ng/mL and 163 vs 135 IU/L, respectively). Black men were significantly younger than nonblack men at the start of radium-223 therapy (mean 67 vs 70 years).

Despite this potentially later receipt of radium-223, black men had a significant 25% decreased risk of death compared with nonblack men on multivariable analysis. This finding is consistent with recent data from other studies showing that among men with mCRPC, black men treated equally as white men with any of the life-prolonging therapies have improved survival. The exact reason for this improved survival remains unclear, but is the subject of active research.


Zhao H, Howard L, De Hoedt A, et al. Racial disparities in radium-223 treatment in a large real world population.Data presented at the 2019 Genitourinary Cancers Symposium held in San Francisco, February 14-16. Abstract 190.