{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T19:41:01Z","timestamp":1772134861845,"version":"3.50.1"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,7,4]],"date-time":"2025-07-04T00:00:00Z","timestamp":1751587200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,7,4]],"date-time":"2025-07-04T00:00:00Z","timestamp":1751587200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Prostate Cancer Prostatic Dis"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      For metastatic and certain advanced prostate cancer (PC), guidelines support intensified androgen deprivation therapy (ADT) as first-line (1\u2009L) systemic treatment. However, some patients receive ADT alone, leading to tumor progression requiring 2\n                      <jats:sup>nd<\/jats:sup>\n                      line therapy. Despite racial disparities in PC outcomes, there are no population-level studies assessing racial differences in time to subsequent treatment after 1\u2009L ADT.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a retrospective population-level analysis to assess the association between race and time to subsequent treatment after ADT in the Veterans Affairs Health Care System. Primary outcome was time from ADT monotherapy to subsequent treatment, defined as receipt of androgen receptor pathway inhibitor (ARPI), non-steroidal first-generation anti-androgen (NSAA), chemotherapy, or other treatments. We used Cox competing risks models and Kaplan-Meier (KM) analyses to estimate subsequent treatment rates by Non-Hispanic White [NHW], Non-Hispanic Black [NHB], Hispanic and Other patients, adjusted for baseline covariates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      From 2001\u20132021, 141,495 PC patients received ADT alone. During median (IQR) follow-up of 51.1 (22.8, 97.2) months, 28,144 patients (20%) had subsequent treatment: 11,319 (40%) ARPIs, 12,990 (46%) NSAAs, 3402 (12%) chemotherapy and 433 (2%) other 2\n                      <jats:sup>nd<\/jats:sup>\n                      line therapies. NHB had significantly lower subsequent treatment rates (HR\u2009=\u20090.82, 95% CI\u2009=\u20090.80\u20130.85) vs. NHW. Both Hispanic (HR\u2009=\u20090.93, 95%CI\u2009=\u20090.88\u20130.98) and Other men (HR\u2009=\u20090.91, 95%CI\u2009=\u20090.84\u20130.98), also had lower subsequent treatment rates. When stratified by age, associations between race\/ethnicity and time to subsequent treatment were stronger in younger patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>All races examined had significantly lower rates of subsequent treatment after 1\u2009L ADT relative to NHW, especially in younger patients. Further investigation is needed to determine if these lower rates of subsequent treatment reflect lower rate of progression or undertreatment of progressing patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1038\/s41391-025-00995-4","type":"journal-article","created":{"date-parts":[[2025,7,4]],"date-time":"2025-07-04T08:16:02Z","timestamp":1751616962000},"page":"103-110","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Assessing racial differences in time to subsequent treatment following androgen deprivation therapy among Veterans with prostate cancer"],"prefix":"10.1038","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6713-0614","authenticated-orcid":false,"given":"Nadine A.","family":"Friedrich","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0560-0748","authenticated-orcid":false,"given":"Jessica L.","family":"Janes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3636-5688","authenticated-orcid":false,"given":"Joshua","family":"Parrish","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3899-7702","authenticated-orcid":false,"given":"Amanda M.","family":"De Hoedt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janis","family":"Pruett","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Fallick","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raj","family":"Gandhi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agnes","family":"Hong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas P.","family":"Tatonetti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8104-6419","authenticated-orcid":false,"given":"Stephen J.","family":"Freedland","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,7,4]]},"reference":[{"key":"995_CR1","doi-asserted-by":"publisher","first-page":"479","DOI":"10.6004\/jnccn.2019.0023","volume":"17","author":"JL Mohler","year":"2019","unstructured":"Mohler JL, Antonarakis ES, Armstrong AJ, D\u2019Amico AV, Davis BJ, Dorff T, et al. Prostate Cancer, Version 2.2019, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw. 2019;17:479\u2013505. https:\/\/doi.org\/10.6004\/jnccn.2019.0023.","journal-title":"J Natl Compr Canc Netw"},{"key":"995_CR2","doi-asserted-by":"publisher","first-page":"365","DOI":"10.3978\/j.issn.2223-4683.2015.05.02","volume":"4","author":"T Chandrasekar","year":"2015","unstructured":"Chandrasekar T, Yang JC, Gao AC, Evans CP. Mechanisms of resistance in castration-resistant prostate cancer (CRPC). Transl Androl Urol. 2015;4:365\u201380. https:\/\/doi.org\/10.3978\/j.issn.2223-4683.2015.05.02.","journal-title":"Transl Androl Urol"},{"key":"995_CR3","doi-asserted-by":"publisher","first-page":"380","DOI":"10.5489\/cuaj.10167","volume":"4","author":"F Saad","year":"2010","unstructured":"Saad F, Hotte SJ. Guidelines for the management of castrate-resistant prostate cancer. 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All other authors report no proprietary or commercial interest in any product mentioned or concept discussed in this article. This study was presented at ASCO 2023 Annual Meeting.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"All methods were performed in accordance with relevant guidelines and regulations, including the Declaration of Helsinki. The study was approved by the Durham VAHCS IRB (MIRB #1827), which permitted access to medical records for Veterans with prostate cancer nationwide. Informed consent was waived due to the retrospective nature of the study and use of de-identified data.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}}]}}