Abstract B081: Biological and neighborhood-level social drivers of aggressive prostate disease among Black and White men
Authors: Cullen Jennifer , Liu Tao , Rodland Karin , Ghosh Ranjini , Alfahmy Anood , Payne Julia , Balaji Sweta , Hartman Holly , Ponsky Lee , Shoag Jonathan , MacLennan Gregory 
Published: December 2023

Introduction and study purpose: Prostate cancer (PCa) is the leading type of newly diagnosed cancer and second leading cause of cancer death in American men. Significant racial differences in PCa incidence and mortality have been long-reported in the U.S., with Black men demonstrating a disproportionately higher burden of disease compared to White men. However, some studies conducted in equal access health care settings have revealed equivalent PCa outcomes for White and Black men. Identification of early predictors of prostate disease aggressiveness is essential to avoid over-treatment of clinically favorably disease that is unlikely to progress. This study examines the independent and joint roles of biological and social determinants of health (SDOHs) in predicting prostate disease aggressiveness in a racially diverse cohort of men undergoing biopsy for suspicion of PCa. Methodology: A retrospective cohort study was conducted at the University Hospitals (UH) Seidman Cancer Center in Cleveland, Ohio for the period January 1, 2005-December 2022. A retrospective chart review was conducted to identify eligible men, including White and Black men undergoing transrectal ultrasound-guided biopsy whose biopsy results included the following 3 groups: (i) negative biopsy with a history of 1+ negative biopsy (-ies) and no history of prostate cancer; (ii) biopsy-detected PCa of Gleason sum 6; and (iii) biopsy-detected PCa with metastasis (-es) at initial cancer detection. Detailed clinical and biological specimen data were abstracted and quantitative proteomics analysis of biopsy tissues using mass spectrometry has been conducted at the Pacific Northwest National Laboratory (PNNL). Residential addresses were used to link each man to his census-block group Area Deprivation Index (ADI) score, as a metric of SDoHs. Students t-tests, ANOVAs and Pearson correlation analysis have been performed on the first 60 eligible subjects.  Results: This study has generated the entire proteome on the first 60 eligible subjects (“Discovery cohort”) and SDoH metrics have been linked to the first 284 of 300 eligible subjects. Among the first 60 subjects, there was strong separation in proteome profiles for metastatic PCa cases but little separation of Gleason 6 and biopsy negative subjects was observed. Interesting, among the proteins that showed significant correlation with clinical group, few proteins were also significant correlated with subject race. However, several oproteins were strongly associated with SDoHs. Conclusions: Identifying new markers of cancer aggressiveness within and across race has the potential to tailor disease management and identify patients who are likely to benefit from earlier, timely treatment interventions, which will ultimately improve prostate cancer outcomes and quality of life. Upon completion of targeted proteomic analyses, we will perform multi-level modeling to predict prostate disease aggressiveness as a function of protein biomarker candidates in combination with census block group-level SDOHs. 

Citation Format: Jennifer Cullen, Tao Liu, Karin Rodland, Ranjini Ghosh, Anood Alfahmy, Julia Payne, Sweta Balaji, Holly Hartman, Lee Ponsky, Jonathan Shoag, Gregory MacLennan. Biological and neighborhood-level social drivers of aggressive prostate disease among Black and White men [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B081.