在美国，黑人男性患前列腺癌（PC）相关死亡率比其他种族的男性更高。但是，几项真实世界的晚期PC研究表明，黑人男性对新型激素治疗的反应比白人男性更好。有关吗啡酮对种族的治疗反应的数据有限。我们评估了使用恩扎鲁胺治疗的化疗前PC的黑人和白人男性的真实世界前列腺特异性抗原（PSA）反应和临床无进展生存期（cPFS）。 这项回顾性队列研究包括在IntrinsiQ Specialty Solutions™数据库中从2014年到2018年开始接受恩扎鲁胺治疗的PC患者，这是一个来自社区泌尿科诊所的电子医疗记录收集。指数日期是第一张恩扎鲁胺处方的日期，用作代理转移性去势抗药性PC（mCRPC）。被化疗和/或阿比特龙治疗的患者被排除在外。用Kaplan-Meier和Cox模型根据基线特征来估计种族间的PSA反应和cPFS。 该研究包括214名黑人男性和1332名白人男性，他们患的化疗前PC被认为是有mCRPC的，因为在研究期间使用了恩扎鲁胺的指示。黑人男性年龄较小，基线中位PSA水平比白人男性高。种族之间使用恩扎鲁胺治疗的时间、随访时间和指标后的PSA检测次数相似。在多变量分析中，患者达到≥50% PSA下降的风险相似，而黑人男性观察到≥90% PSA下降的趋势更高（HR1.23; 95% CI 0.93-1.62 [P = 0.14]）。在多变量分析中，黑人男性的cPFS显著更好（HR 0.82; 95% CI 0.68-0.98 [P = 0.03]）。 使用恩扎鲁胺治疗的被认为未接受化疗的mCRPC黑人和白人男性的PSA反应相似，但是黑人男性的cPFS比白人男性更好。需要进一步研究来验证这些发现。 ©2022。作者（们）。

In the United States, Black men have a higher incidence of prostate cancer (PC)-related mortality than men of other races. Several real-world studies in advanced PC suggest, however, that Black men respond better to novel hormonal therapies than White men. Data on treatment responses to enzalutamide by race are limited. We assessed real-world prostate-specific antigen (PSA) response and clinical progression-free survival (cPFS) of Black vs. White men with chemotherapy-naïve PC treated with enzalutamide.This retrospective cohort study included patients with PC who initiated enzalutamide treatment from 2014 to 2018 in the IntrinsiQ Specialty Solutions™ database, a collection of electronic medical records from community urology practices. Index date was the date of the first prescription for enzalutamide, used as a proxy for metastatic castration-resistant PC (mCRPC). Patients who had undergone chemotherapy and/or abiraterone therapy were excluded. Kaplan-Meier and Cox models adjusted for baseline characteristics were used to estimate PSA response and cPFS by race.The study included 214 Black and 1332 White men with chemotherapy-naïve PC presumed to have mCRPC based on the enzalutamide indication during the study period. Black men were younger and had higher baseline median PSA levels than White men. Enzalutamide therapy duration, follow-up time, and number of post-index PSA tests were similar between races. In multivariable analyses, the risk of patients achieving a ≥ 50% PSA decline was similar, whereas a numerically higher trend of ≥90% PSA decline was observed in Black men (HR 1.23; 95% CI 0.93-1.62 [P = 0.14]). In the multivariable analysis, Black men had significantly better cPFS (HR 0.82; 95% CI 0.68-0.98 [P = 0.03]).Black and White men with presumed chemotherapy-naïve mCRPC had similar PSA responses when treated with enzalutamide, but Black men had better cPFS than White men. Further research is warranted to validate these findings.© 2022. The Author(s).