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Immunotherapy may help men with prostate cancer. Getty Images
  • New research conducted by scientists at Northwestern University finds Black men may have a genetic advantage when it comes to immunotherapy treatments for prostate cancer.
  • The reason is that Black men are more likely to have a type of cell on their tumors that can be targeted.
  • Black men are disproportionately more likely to get and die of prostate cancer than white men.

Prostate cancer is a risk for all men but can be especially deadly for African-American men, who have higher mortality rates than other groups.

“We know that African-American men are more than twice as likely to be diagnosed with prostate cancer and essentially have higher mortality rates,” Dr. Manish A. Vira, System Chief of Urology, Northwell Health Cancer Institute in New York, told Healthline.

But new research has found that Black men may benefit more from new therapies called immunotherapy, which stimulates the immune system to fight cancer.

Now, a new study conducted by scientists at Northwestern University uncovers why this group may have a genetic advantage when it comes to immunotherapy treatments.

The new study, published this week in Nature Communications, finds that the prostate tumors from Black men and men of African ancestry have a greater proportion of plasma cells (a type of immune cell) than those in the tumors of white men.

Vira said more of these plasma cells can be protective.

“That African-American men had a higher preponderance of these cells that were in the tissues, and that higher levels tended to be protective, that those patients had a better outcome,” he explained.

New immunotherapy treatments may be able to target these cells and reduce the tumor.

The increase in plasma cells was associated with improved cancer survival following surgery. Researchers identified plasma cells as possibly driving prostate cancer immune-responsiveness.

“If a man’s prostate cancer has numerous plasma cells, we found he had improved cancer survival,” Dr. Edward Schaeffer, study lead researcher and the Edmund Andrews Professor of Urology at Northwestern University, said in a statement. “Our study suggests plasma cells are important in the body’s response to cancer.”

Immunotherapy, which is a broad term, refers to “the practice of using your immune system to help fight off prostate cancer,” explained Dr. Art R. Rastinehad, vice chair of urology at Lenox Hill Hospital in New York.

The treatment is also used in certain cases to fight prostate cancer that has become resistant to other therapies to improve the odds of survival.

“Immunotherapy comes in many different forms in cancer therapy in general,” said Vira. “In prostate cancer, commonly the only approved immunotherapy is a medication called Provenge, also known as sipuleucel-T.”

He explained that with Provenge, patients’ white blood cells are drawn from their blood through plasmapheresis. They are then exposed to proteins that train them to recognize and fight prostate cancer cells and then inserted back into the body.

The Northwestern team’s work showed improved cancer-free survival following surgery in all men with higher levels of plasma cells, not only Black men.

Black men tend to have higher levels of these plasma cells compared to other demographic groups.

Researchers are now developing immunotherapy-based precision medicine clinical trials to find out whether increased levels of plasma cells in prostate cancers from men of all races and ancestry can enhance immunotherapy for improved survival.

“The finding comes at a time as researchers are discovering plasma cells may play a greater role in cancer immunotherapy than previously thought,” Dr. Adam Weiner, a Northwestern Medicine urology resident, said in a statement. “Testing for plasma cells in prostate cancer may help identify men who will benefit from immune-based treatments.”

The news is a bright spot as health experts have known that Black men in America face higher risks from prostate cancer than other demographic groups.

Vira said that while age is the greatest risk factor, “The incidence of prostate cancer rises as men get older.”

“In terms of race and background, it certainly has an influence,” he said. “We know that African-American men are more than twice as likely to be diagnosed with prostate cancer and essentially have higher mortality rates.”

Rastinehad believes socioeconomic factors may play a role for why Black men in America are more likely to get prostate cancer and to die from it.

“It is not exactly clear, but there have been studies to dispel the idea that patients with African ancestry harbor more aggressive variants,” said Rastinehad.

Research conducted in 2012 found that bias and discrimination have played an important role in “populations with otherwise equal access to healthcare.”

“The prevailing thought is that access to care plays a major role in the impact of the disease, time of diagnosis, and stage at diagnosis on these populations, which may be attributable to their socioeconomic status,” Rastinehad said.

Vira agreed that access to care must be considered, and confirmed that, “Obviously, health disparities are important.”

Whether a close relative has had prostate cancer is something else to consider for cancer risk.

“Any man who has a family history of prostate cancer in the first degree relatives,” said Vera. “Whether it be their brother or father, but one first degree relative will increase your risk.”

The American Cancer Society (ACS) recommends men take these actions to reduce the odds of developing prostate cancer:

  • Maintain a moderate body weight
  • Stay physically active
  • Eat a diet that includes whole grains and colorful fruits/vegetables
  • Avoid or limit red and processed meats, sugar-sweetened beverages, and highly processed foods

The ACS also advises men at high risk for prostate cancer, including Black men, to begin being screened for the disease by age 45.

While Black men tend to have poorer outcomes after being diagnosed with prostate cancer, new research finds they may have an advantage in a treatment called immunotherapy.

Researchers found they typically have larger amounts of special immune cells than white men, improving their survival odds. They also found that men of any race with more of these cells have better outcomes with immunotherapy.

Experts say it’s unclear why Black men have higher mortality rates with prostate cancer but believe racial disparities in healthcare access may play a role.