In two studies of African-American women with endometrial cancer, a group of investigators from Walter Reed Army Medical Center and the National Cancer Institute has found that African-American women with advanced endometrial cancer have more aggressive tumors than Caucasian women, potentially leading to worse outcomes.
Specifically, the investigators first performed a retrospective study of data from four treatment trials carried out by the Gynecologic Oncology Group (GOG) in a clinical trial setting where patients receive similar care, to determine if outcomes remain poor for African-American women with endometrial cancer. The GOG is an NCI-funded national cooperative group that coordinates most of the large therapeutic gynecologic cancer studies in the U.S.
In this study, the survival rates for 168 African-American patients and 997 Caucasian patients with Stage III, Stage IV or recurrent endometrial cancer were analyzed and compared. This analysis showed that African-American women with advanced endometrial cancer have a 25 percent greater chance of dying than Caucasian patients with the same diagnosis, even in the setting of a controlled clinical trial.
Based on the clinical data from the GOG study, the investigators hypothesized that there may be biologic differences in endometrial cancers in African-American women compared to Caucasian women that lead to more aggressive tumors. The investigators subsequently performed a study evaluating global gene expression among patients with advanced endometrial cancer using tumor samples from patients treated at Duke University Medical Center.
Cancers from 18 African-American patients were compared to those from 27 Caucasian patients who were matched according to stage, grade and cell type.
It was found that distinct and different patterns of gene expression may characterize advanced endometrial cancers in African-American and Caucasian women, and that these underlying molecular differences may partially explain the racial disparity in survival outcome.
More information about the studies can be found in the manuscripts: