Mutational burden among patients with metastatic prostate cancer differs by race in 3 key genes: An analysis of genomic and clinical data from the AACR Project GENIE biopharma collaborative in cBioPortal.

5106 Background: Prostate cancer exhibits a range of aggressive oncological traits due to its genomic heterogeneity. The extent to which clinical and demographic variables affect cancer behaviors and increase disparities is a complex and open question. Objective: We aim to comprehensively explore the genomic and epigenetic characteristics of metastatic prostate cancer (PCa) across different racial groups to elucidate potential molecular and immune mechanisms underlying disparities in disease progression and treatment response. Methods: Data from the Association for Cancer Research Project Genomics Evidence Neoplasia Information Exchange (AACR-GENIE) registry to study men diagnosed with PCa was queried. Patients with metastatic disease (n = 1,684) were stratified into three racial groups: White (80.5%), Black (8.1%), and Asian (3.1%). cBioPortal was used to analyze the differences in genetic mutation frequencies by race and to determine the importance of these mutations. The relationships between mutation frequencies and race were examined using chi-squared test. Results: In our study, among patients with metastatic prostate cancer, the following three genes demonstrated the highest differences in frequencies of mutation: TP53, ATR, and PTEN. The most significant differences in mutation frequencies by race in metastatic PCa patients were found in TP53 (White: 3.1%; Black: 16.7%; Asian: 11.8%; P <0.005) and ATR (White: 2.39%; Black: 3.58%; Asian: 4.87%; P = 0.035). PTEN has a metastatic tumor frequency of 6.5% in Asians, 4.2% in Black men, and 7.1% in White men (P = 0.0434). Conclusions: Consistent with previous literature, our study provides new insight into the complex interplay between PCa pathogenesis and progression, paving the way for precision. In the TP53 gene, Black men were more likely than their counterparts to have a higher mutational burden. This research has significant implications for improving health equity in PCa.