title: Racial differences in CYP3A4 genotype and survival among men treated on Radiation Therapy Oncology Group (RTOG) 9202: a phase III randomized trial.
abstract: OBJECTIVE
  Inherited genotypes may explain the inferior outcomes of African American (AA) men with prostate cancer. To understand how variation in CYP3A4 correlated with outcomes, a retrospective examination of the CYP3A4 *1B genotype was performed on men treated with Radiation Therapy Oncology Group (RTOG) 92-02.
  
  
  METHODS
  From 1,514 cases, we evaluated 56 (28.4%) of 197 AA and 54 (4.3%) of 1,274 European American (EA) patients. All patients received goserelin and flutamide for 2 months before and during RT (STAD-RT) +/- 24 months of goserelin (long-term androgen deprivation plus radiation [LTAD-RT]). Events studied included overall survival and biochemical progression using American Society for Therapeutic Radiology and Oncology consensus guidelines.
  
  
  RESULTS
  There were no differences in outcome in patients in with or without CYP3A4 data. There was an association between race and CYP3A4 polymorphisms with 75% of EAs having the Wild Type compared to only 25% of AA men (p <0.0001). There was no association between CYP3A4 classification or race and survival or progression.
  
  
  CONCLUSIONS
  The samples analyzed support previously reported observations about the distribution of CYP3A4 *1B genotype by race, but race was not associated with poorer outcome. However, patient numbers were limited, and selection bias cannot be completely ruled out.
authors.affiliation: Department of Radiation Oncology, University of California San Francisco, San Francisco, CA, USA. mroach@radonc.ucsf.edu
authors.forename: Mack
authors.initials: M
authors.lastname: Roach
authors.forename: Michelle
authors.initials: M
authors.lastname: De Silvio
authors.forename: Timothy
authors.initials: T
authors.lastname: Rebbick
authors.forename: David
authors.initials: D
authors.lastname: Grignon
authors.forename: Marvin
authors.initials: M
authors.lastname: Rotman
authors.forename: Harvey
authors.initials: H
authors.lastname: Wolkov
authors.forename: Barbara
authors.initials: B
authors.lastname: Fisher
authors.forename: Gerald
authors.initials: G
authors.lastname: Hanks
authors.forename: William U
authors.initials: WU
authors.lastname: Shipley
authors.forename: Alan
authors.initials: A
authors.lastname: Pollack
authors.forename: Howard
authors.initials: H
authors.lastname: Sandler
authors.forename: Deborah
authors.initials: D
authors.lastname: Watkins-Bruner
mesh_terms: D000368:Aged; D000726:Androgen Antagonists / Q000627:therapeutic use; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D044383:Black People; D051544:Cytochrome P-450 CYP3A; D003577:Cytochrome P-450 Enzyme System / Q000235:genetics*; D018450:Disease Progression; D005485:Flutamide / Q000627:therapeutic use; D005838:Genotype; D017273:Goserelin / Q000627:therapeutic use; D006801:Humans; D008297:Male; D009363:Neoplasm Proteins / Q000235:genetics*; D017410:Practice Guidelines as Topic; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000201:enzymology / Q000208:ethnology* / Q000401:mortality* / Q000532:radiotherapy; D012044:Regression Analysis; D013534:Survival; D044465:White People; D001741:Black or African American
chemical_list: D000726:Androgen Antagonists; D018931:Antineoplastic Agents, Hormonal; D009363:Neoplasm Proteins; D017273:Goserelin; D005485:Flutamide; D003577:Cytochrome P-450 Enzyme System; D051544:Cytochrome P-450 CYP3A; C510163:CYP3A4 protein, human; D017430:Prostate-Specific Antigen