Rotimi, Solomon O.

Abstract Black/African American populations, globally, bear the greatest prostate cancer (CaP) burden compared to other racial/ethnic groups. Addressing CaP disparities in Black men is complex, requiring a patient-centered, community-centric and comprehensive approach. This study integrates iCCaRE Consortium findings and broader literature to address unmet needs in survivorship care. The iCCaRE Consortium implemented five complementary pilot studies using mixed-methods designs, including feasibility trials, qualitative research, and observational analyses across the United States and sub-Saharan Africa. Descriptive statistics, subgroup analyses, and qualitative thematic analyses were performed across these studies. Collectively, projects addressed multilevel determinants including social, behavioral, and biological drivers of disparities. Project 1 implemented a Virtual Reality Assistant (ViRA) across clinical and community settings, with ongoing evaluation in pragmatic trials. Project 2 showed strong patient preference for home-based cancer care. Project 3 enrolled demonstrated trends toward improved health-related quality of life. Project 4 identified key themes influencing survivorship experiences. Project 5 identified biological mechanisms linking stress, immune modulation, and symptom burden. The iCCaRE pilot projects demonstrate the feasibility and early impact of a consortium-based, transdisciplinary approach to addressing CaP disparities in Black men. These findings highlight the importance of integrating patient-centered interventions, community engagement, and biological insights to inform scalable strategies aimed at improving survivorship outcomes and advancing health equity. The iCCaRE Consortium demonstrates that a transatlantic, patient-centered, and multidisciplinary approach integrating social, clinical, and biological factors can generate scalable strategies to improve survivorship outcomes and advance equity in CaP care for Black men.

Abstract Background: Black men across the African Diaspora experience a disproportionate burden of prostate cancer (CaP). The Inclusive Cancer Care Research Equity (iCCaRE) Consortium aims to eliminate CaP burden through global scientific collaboration, innovative research, community-engaged interventions, and next-generation workforce development. The primary objective for this Consortium was to optimize CaP diagnosis, treatment, and survivorship through research, research training and education, community engagement and community outreach. The Consortium integrates digital health technologies, community navigation, precision communication and precision science. Methods: Five full projects and one pilot project were launched across partner institutions in North America and Africa. Supported by multiple cores and services, the research activities included (1) implementation of a Point of Prostate Cancer Diagnosis Virtual Robot Assistant (PPCD-ViRA); (3) initiation of a cancer care at home trial; (4) migrant health studies of Caribbean and Sub-Saharan African immigrants; (5) expansion of genomic and metabolomic research; and (6) digital, psychosocial, and survivorship intervention development. Training and dissemination activities were deployed through iCCaRE TV, webinars, and community engagement programs including the Global Prostate Health Dialogue (Glo-PHD). Results: In one year, accomplishments included 45 presentations, 17 publications, 16 grant submissions, and 3 awards. The consortium delivered 408 live webinar engagements and reached more than 400 men globally through Glo-PHD. PPCD-ViRA was fully developed and prepared for clinical deployment (see https://www.youtube.com/watch?v=1mI-HS5R6sk). The African cohort expansion for genomic and metabolomic profiling was activated across several countries, with biospecimen collection underway. Media dissemination generated more than 15,000 views across platforms, including high-impact educational videos (see: www.youtube.com/@iCCaREConsortium). Training achievements included 13 early-career investigators and 7 trained prostate cancer advocates. Conclusions: In just one year, the iCCaRE Consortium Phase 2 made substantial progress toward transforming CaP equity globally. Through multidisciplinary science, digital innovation, and community partnerships, the consortium is building scalable infrastructure to address diagnosis experiences, treatment quality, and survivorship among Black men. Ongoing efforts will continue to advance precision medicine, culturally grounded interventions, and global capacity building. Citation Format: Folakemi T. Odedina, Arnold Merriweather, Roxana S. Dronca, Ernest T. Kaninjing, Solomon Rotimi, Gerardo Colon-Otero, Kimlin Ashing, Ademola A. Popoola, Gladys Asiedu, Opeyemi Bolajoko, Ewan COBRAN, Emelina Asto-Flores, Floyd Willis, Christopher Williams, Monica L. Albertie, Michelle Fudge, Oluwaseyi Toye, Collisa Mahin, Jada Melton, Inclusive Cancer Care Research Equity (iCCaRE) Consortium, Prostate Cancer Transatlantic Consortium (CaPTC). Achieving prostate cancer equity globally: Multinational advances from the iCCaRE consortium [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2026; Part 1 (Regular Abstracts); 2026 Apr 17-22; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2026;86(7 Suppl):Abstract nr 2382.

Abstract Background: Prostate cancer (PCa) is the leading cause of cancer-related deaths globally and disproportionately affects men of African ancestry. African men often present at younger ages and with more aggressive disease, and approximately half of the PCa risk has been attributed to genetic factors. Africa is the most genetically diverse region of the world, and even within the continent, populations show important differences in allele frequencies and patterns of pathogenic variation. Despite this diversity, African men remain underrepresented in genomic studies, creating significant gaps in knowledge that limit precision medicine efforts. Methods: A total of 182 prostate cancer patients were recruited from teaching hospitals in Benin, Côte d’Ivoire, Ghana, Kenya and Nigeria. 50 cancer susceptibility genes using the Aviseq ONCO50 panel and the Illumina MiSeq platform. Variant calling was performed using an in-house Snakemake workflow, followed by additional bioinformatic steps to distinguish true PMS2 variants from PMS2CL-related artifacts. Pathogenicity assessment relied on annotations from ClinVar and LOVD databases. Results: Pathogenic and likely pathogenic variants were detected in 31.3% of the study group identified in 26 genes. The five most frequently altered genes were RAD50, PTCH1, MSH6, MUTYH, and NF1. Nigerian patients accounted for 52.6 percent of all pathogenic variants, with recurrent alterations observed in MSH6, MUTYH, NF1, and PTCH1. In contrast, pathogenic BRCA1 and BRCA2 variants were observed primarily in patients from Kenya, Benin, and Côte d’Ivoire. Several frameshift, nonsense, and splice-site variants identified in this study have not been previously reported in African populations.[SR1] Conclusion: This study provides one of the most detailed assessments of inherited cancer susceptibility gene variants in African PCa patients. The findings reveal substantial regional variation in the spectrum of pathogenic variants and highlight population-specific genomic signatures that may contribute to the unequal burden of PCa in men of African ancestry. These data emphasize the importance of expanding genomic research efforts within Africa to strengthen precision oncology and reduce global PCa disparities. Citation Format: Abimbola F. Onyia, Freeman Okwuchi, Opeyemi C. De Campos, Sylvester Divine, Olutola Olasehinde, Ayinde Yahaya, Ayo Salako, Aminu Zakari, Iya Bassey, Nicholas Titiloye, Bernard Petershie, Isidore GANDAHO, Luc Brun, Tore Sanni, Safiatou Coulibaly, Noel Coulibaly, Michael Fakayode, Coulibaly Issoufou, Valérie Gbonon, Kouame Benjamin, Yao Evrard, Peter Coleman, Ayun Cassell, Victor Ajumbo, Lilac Wattanga, Benson Ochieng Nyambega, Folakemi T. Odedina, Solomon Rotimi. Targeted sequencing of common cancer susceptibility genes reveals germline variants in African prostate cancer patients [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2026; Part 1 (Regular Abstracts); 2026 Apr 17-22; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2026;86(7 Suppl):Abstract nr 6289.

Abstract Background: Sub-Saharan African Immigrants (SSAI) represent one of the fastest-growing segments of the immigrant population in the United States (US). Between 2010 and 2018, the SSAI population in the US increased by 53%, significantly outpacing the 12% growth rate for the overall foreign-born population in the US during that time frame. Despite these growing numbers, little is published about the extent to which SSAIs adapt to health behaviors more common in the US or remain immersed in the values, beliefs and practices reflective of their country of origin. Importantly, no study has comprehensively examined the Social Determinants of Health (SDOH) among this population relative to their migration experiences and their influence on health-seeking behaviors and decision-making regarding prostate cancer care and treatment options. Methods: This qualitative study employed grounded theory and the social determinants of migrant heath framework to better understand the needs of SSAI prostate cancer survivors in the United States and how to effectively support these survivors. In-depth interviews were conducted with 8 survivors who live in the states of Florida and Minnesota. Findings: Some participants reported limited access to care and financial challenges paying for drugs. In terms of coping with diagnosis and treatment, most of the participants relied on their faith, a positive outlook about survivorship and support of family members. Some participants relied on the coaching and support of a loved one who experienced prostate cancer in the past. Erectile dysfunction severely impacted the sexual life of most participants as they experienced difficulty getting an erection. Conclusion: Participants expressed the benefit of belonging to support groups with other survivors for social and emotional support. As the number of immigrants from sub-Saharan continue to rise, so too will the demand for culturally tailored care to address and reduce disparities in survivorship among this sub-population. Citation Format: Ernest Kaninjing, Gladys Asiedu, Kaitlin Van Voorhis, Mary Ellen Young, Ebenezer Erefah, Emmanuel Agboola, Folakemi Odedina, Roxana Dronca, Kimlin Ashing, Solomon Rotimi, Che Ngufor, Arnola Merriweather, John McCall, Anthony Hill. Social determinants of migrant health factors impacting prostate cancer care and survivorship among sub-Saharan African immigrant men diagnosed with prostate cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 1310.

Abstract Monoclonal gammopathy of undetermined significance (MGUS) is a premalignant condition characterized by plasma cell production of monoclonal (M) protein and is a requisite precursor to multiple myeloma (MM). African American (AA) individuals have a two-fold higher incidence of MGUS and MM compared to White individuals. However, data are limited on individuals from Africa, especially using sensitive MGUS detection methods. We examined the prevalence of MGUS in a sample of the general population in Nigeria. Individuals aged 40 and over (n=343) were recruited through health promotion events in Ado-Odo Ota Local Government Area of Ogun State, Nigeria, and provided informed consent, a blood sample, and a short questionnaire. Serum was screened at Mayo Clinic for heavy chain (HC)-MGUS using the matrix-assisted laser desorption/ionization-time of flight (Mass-Fix) assay, which has high sensitivity for detection of M-proteins; serum free light chains (FLC) were also measured. FLC was abnormal if the kappa (>0.26 mg/dL) or lambda (>0.33 mg/dL) light chain (LC) was elevated and FLC ratio (kappa/lambda) was outside the reference range (0.26-3.10). LC-MGUS was defined as an abnormal FLC in the absence of a HC. Age- and sex-adjusted prevalence rates were directly standardized to 2010 United States (US) population for comparison to published studies. Logistic regression was used to examine the association of age, sex, and BMI with HC-MGUS. The mean age of participants was 55 years (SD=10.9), and 74.6% were female. Of these, 216 (63%) had both parents from the Yoruba tribe, 89 (26%) from the Igbo tribe and 38 (11%) from other tribes. Overall, 33 participants (9.6%) had HC-MGUS, with 8 (2.3%) having an M-protein above 0.2 g/dL; 6 (1.7%) had LC-MGUS. HC-MGUS was predominantly IgG isotype (48.5%), followed by IgA (27.3%), biclonal (15.2%) and IgM (9.0%). Prevalence of HC-MGUS was 8.3% for ages 40-49, 7.7% ages 50-69 and 22% ages 70 and above. Standardized to the US population, age and sex adjusted MGUS prevalence ages 50 and older was 17.3% (95% CI: 9.8%-24.9%) and HC-MGUS was 14.7% (95% CI: 7.7%-21.8%), similar to previously published rates of HC-MGUS using Mass-Fix screening of AA individuals (16.5%, 95% CI: 12.2%-20.8%) (PMID: 35316833). In models that included age, sex and BMI, older age was positively associated with HC-MGUS (OR=3.1, 95% CI: 1.1-8.7 for ages 70+ compared to <50), while female sex (OR=0.53, 95% CI: 0.24-1.2) and overweight/obesity (OR=0.34, 95% CI: 0.16-0.75 for BMI > 25 vs. <25) were inversely associated with HC-MGUS. We observed similar prevalence of HC-MGUS at ages 50 and above among Western Nigerian and AA populations when screened using mass-spectrometry. Older age was positively associated with HC-MGUS while overweight and obesity were inversely associated. Studies of MGUS in indigenous African populations may provide insight to unique cancer risk factors compared to other populations. Citation Format: Celine M. Vachon, Cristine Allmer, Danelle Moonen, Aaron Norman, Joselle Cook, Susan Slager, Oluwakemi A. Rotimi, Opeyemi C. De Campos, Titilope M. Dokumu, David Murray, Shaji Kumar, Elizabeth Brown, Linda B. Baughn, Solomon Rotimi. Prevalence of monoclonal gammopathy of undetermined significance (MGUS) in a Western Nigerian population [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 3455.

Abstract Prostate cancer (CaP) is a heterogeneous disease characterized by features of non-aggressive, slow-growing disorders to fast-growing disease. Men of African ancestry have disproportionately higher incidence and mortality rates for CaP than men of European ancestry. While there is evidence for a higher genetic predisposition for incidence of CaP in men of African ancestry compared to men of European ancestry, there is paucity of molecular biology and transcriptomic studies on the role of Human endogenous retroviruses (HERVs) in relation to CaP-associated genes in CaP pathogenesis and prognosis. In this study, we performed bulk RNA sequencing (RNA-seq) on formalin-fixed paraffin-embeded (FFPE) CaP samples from Nigerian CaP patients to investigate the expression significance of HERV-R in relation to FOXA1, TMPRSS2, BAZ1B, KMT2D, ATF4 and BRAF genes. Based on this findings, we used immunohistochemistry (IHC), enzyme-linked immunosorbent assay (ELISA) and immunofluorescence (IF) to confirm the expression pattern of the HERV-R and FOXA1, TMPRSS2, BAZ1B, KMT2D, ATF4 and BRAF proteins on 45 FFPE CaP and blood plasma samples, and 5 CaP-free samples from patients in Zaria, Nigeria. Most of these patients were longitudinally followed from 2017 to date. The DESeq2 procedure was used for data processing, analysis, and differential expression analysis of the aforementioned genes. We found a significant expression of HERV-R in relation with FOXA1, TMPRSS2, BAZ1B, KMT2D, ATF4, CCND1 and BRAF in the CaP from rural Africans in Nigeria. HERV-R expression was found to be associated with increased PSA level, higher Gleason grade and poor prognosis of CaP. A CaP sample from an 80-year-old patient that was histologically diagnosed to have no malignancy seen despite high PSA level of >100 and poor disease outcomes shows a significant cytoplasmic expression of HERV-R, indicating that HERV-R may serve as an important biomarker for early detection. Unfortunately, we lost the 80-year-old patient to late detection before revisiting his case for proper histological diagnosis and management. In addition, some histologically diagnosed BPH samples that are apparently reported to be CaP-free show stromal cells expression of HERV-R and in some cases show expression of HERV-R in the prostatic glandular areas. In contrast, stromal cells of the CaP samples show no expression of HERV-R, but strong expression in the glandular areas. This may implicate a gradual transition from benign prostatic lesion to malignant prostatic disease. HERV-R expression in CaP may have a relationship with BRAF, CCND1, FOXA1, TMPRSS2 and ATF4 genes. These findings combined together, underscore the importance of the expanded concept of HERV-R expression and CaP associated genes in early detection of CaP and prognosis. Citation Format: Faruk Mohammed, Konrad Stawiski, Halimatu Sadiya Musa, Sani Kamarudeen Owolabi, Sani Abubakar, Solomon O. Rotimi, Adoke Kasimu Umar, Yawale Iliyasu, Ahmad Bello, Folakemi T. Odedina, Clayton C. Yates, Kevin Petrie, Franklin W. Huang, Sani Ibrahim. Co-expression of HERV-R, CCND1, BRAF, FOXA1, TMPRSS2, ATF4 and low expression of BAZ1B and KMT2D is associated with early detection and poor prognosis of prostate cancer in African Black men from Nigeria [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 6432.

Abstract Introduction: Black men have the highest prostate cancer (CaP) mortality rates. The reason for this disparity is multifaceted, including the barriers that they face at the individual, provider, and health system levels. To address these challenges the iCCaRE for Black Men Consortium uses a multi-level approach to disseminating CaP information. This approach is rooted in research which shows that Black men prefer to receive information through multi-media channels tailored to their needs. In addition, studies have reported that CaP survivors were viewed as credible sources of information. This presentation reports on how iCCaRE Consortium is bridging the digital divide in minoritized communities to disseminate CaP information in a way that is meaningful to the community. Methodology: iCCaRE uses a multimedia method to reach Black men. This includes twitter post, Facebook, YouTube, ecancer and community lunch and learns. In addition to social media, we have partnered with LitTV Network, a locally owned digital TV platform, on which we have iCCaRE TV. On Lit TV network we have the ability to reach 11,000 homes in our catchment area. Furthermore, the consortium has produced informational flyers that are disseminated at outreach events and at the American Legion Post 197. On the twitter page the consortium post: (1) 2 scientific publications per day authored by members of the consortium, (2) 2 weekly “Did You Know” facts about prostate cancer with sources attached, (3) 2 weekly url post sharing a link to a video from the iCCaRE consortium YouTube page and (4) clips of CaP survivors sharing their experiences. On the YouTube page we currently have: videos series of a CaP survivor who is also a physician scientist, interview series with MPIs and members of the consortium, CaP survivor series including a barbershop interview with a survivor. Results: The iCCaRE Consortium multimedia efforts have a global reach, in less than a year we have gained 102 twitter followers. On average the twitter page receives 8,700 impressions during the CaP awareness month in September the twitter page garnered over 14,000 impressions. Our videos on the ecancer platform have a combined global view of 341 representing countries such as the United States, Nigeria, Cameroon, United Kingdom, Macedonia, and Mexico. The American Legion Post 197 in North Jacksonville has served a cumulative of 229 people through outreach and educational event called lunch and learns. Our YouTube channel has had almost 100 views in its first month of being active. Conclusion: Using a multi-level approach to reduce the burden of CaP for Black men is vitally important; without such efforts the disparate thread in mortality will continue to persist. Meeting Black men through the mediums they use for gathering health information removes barriers, increases access and will aid in the fight against CaP for Black Men. Citation Format: Vinessa Gordon, Folakemi Odedina, Kimling Tam Ashing, Arnold Merriweather, Roxana Dronca, Che Ngufor, Solomon Rotimi, Ernest Kaninjing, Abimbola Odedina, John McCall, Anthony Hill, Ayinde Yahaya, Emmanuel Agboola. Fighting prostate cancer with a multimedia approach [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 818.

Abstract The objective of our study is to evaluate the feasibility, acceptance, and impact of patient-centered home care (PCHC) on patient reported outcomes (PROs) and health-related quality of life (HQoL) of black men with advanced prostate cancer (CaP). Meeting patients where they are and offering treatment in or closer to their homes reduce psychological distress and increase treatment compliance, especially for disadvantaged patients in rural areas, those on low incomes, with poor access to transport, elderly and people with disabilities. In 2023, Mayo Clinic has developed the Cancer Care Beyond Walls (CCBW) program, a cancer care delivery model that integrates virtual with in facility treatment and provides a package of care to support administration of cancer-directed therapy (chemotherapy, immunotherapy, hormonal therapy) and/or supportive care in the patients’ homes. Our study will assess if patients and families are comfortable with cancer therapy at home, what factors influences their decision, and use this data to inform our understanding of the proportion of the black men with advanced CaP who would be willing to receive and would benefit from this level of care at home. Patients with advanced CaP from our practice requiring active anti-cancer therapy are administered a brief questionnaire regarding preference for location of therapy at the infusion center or in the home, with perceived difficulties and advantages of each approach. A focus group session with prostate cancer survivor advocates is also conducted to capture patients’ thoughts, feelings, attitudes, and questions towards cancer treatments being administered at home versus a hospital setting. In addition, we are conducting an observational study of 20 patients with advanced prostate cancer receiving supportive care/symptom management and/or anti-cancer therapy in the home as part of the Mayo Clinic CCBW Program to assess the safety of cancer directed therapy when administered at home by a home health provider with remote patient monitoring and command center support, and establish the impact of home cancer treatment administration on patient-reported function and global health/quality of life, patient-reported symptoms, clinical outcomes, and cost of care. Successful completion of the project will deliver data on patient understanding and acceptability of cancer care at home, strategies for overcoming barriers to care for underserved communities, and the foundation from which we discover, translate and apply new knowledge in administering personalized care to vulnerable populations. Citation Format: Roxana S. Dronca, Folakemi Odedina, Che Ngufor, Kimlin Ashing, Ernest Kaninjing, Solomon Rotimi. Feasibility of patient-centered home care (PCHC) to reduce disparities in high-risk black men with advanced prostate cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 819.

Abstract Background: The point of prostate cancer (CaP) diagnosis (PPCD) instantly leads to a life changing experience for Black men, with diverse emotional reactions that includes fear, denial, overwhelmingness, cancer fatalism etc. Black men diagnosed with CaP expressed several needs at the PPCD, including time to reflect on the diagnosis, being comfortable, emotional support, psycho-oncology support and social determinants of health (SDOH) navigation. Given that Black men are diverse in terms of their needs at the PPCD, precision intervention is needed to support them. Aim: The aim was to develop, implement, and establish the acceptance and usability of a Virtual Reality Assistant (ViRA) that will provide precision intervention tailored to the needs of Black men at the PPCD. This study is one of the five iCCaRE for Black Men projects focused on survivorship care. Methodology: The development of the ViRA was guided by CaP survivors through qualitative study. Reflective, analytic, and interpretive memos were used to generate action plans for the development of the ViRA. Based on a comprehensive PPCD ViRA intervention guide created by the team, the ViRA prototype was developed with mobile immersive technologies that integrated SDOH navigation, standard CaP psycho-oncology support and emotional support. The goal was to have the intervention personalized to everyone based on participant-provided information. Alpha testing of the ViRA is ongoing and will be completed on November 20, 2023. Participants are three prostate cancer survivors and three clinicians. The assessments will confirm the accuracy of the ViRA predictions and the functionality of the ViRA. Results: We developed the ViRA SDOH screening and navigation tool to identify participants’ needs and appropriately connect them with relevant support services and resources in their communities. The emotional support intervention was based on four CaP survivors as virtual reality avatars, providing empathetic rapport through self-disclosure and sharing of survivorship stories in different settings (home, clinic, barbershop etc). The psycho-oncology support intervention was developed with the guidance of a psycho-oncologist, with her avatar providing psychoeducation about the PPCD experience, reify and concretize the PPCD experience, and foster hope using the basic tenets of Problem-Solving Therapy. The results of the alpha testing and the modified ViRA will be presented during the conference. Conclusion: Meeting the needs of Black men at the PPCD requires a personalized and decentralized approach, which would allow Black men to access support anywhere. The presentation will unveil the iCCaRE ViRA, a smart and connected personalized AR-enabled intervention that will deliver SDOH navigation, CaP psycho-oncology support and emotional support tailored to the needs of Black men. Citation Format: Folakemi T. Odedina, Che Ngufor, Arnold Merriweather, Deidre Pereira, Roxana Dronca, Ernest Kaninjing, Kimlin Ashing, Solomon Rotimi, Vinessa Gordon, iCCaRE for Black Men Consortium. Connecting Black men to point of prostate cancer diagnosis (PPCD) support using precision intervention based on Virtual Reality Assistant (ViRA) [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2230.

AbstractBackgroundThrough whole‐exome sequencing of 60 formalin‐fixed paraffin‐embedded Nigerian (NGRn) benign prostatic hyperplasia (BPH) samples, we identified germline and somatic alterations in apoptotic pathways impacting BPH development and progression. Prostate enlargement is a common occurrence in male aging; however, this enlargement can lead to lower urinary tract symptoms that negatively impact quality of life. This impact is disproportionately present in men of African ancestry. BPH pathophysiology is poorly understood and studies examining non‐European populations are lacking.MethodsIn this study, NGRn BPH, normal prostate, and prostate cancer (PCa) tumor samples were sequenced and compared to characterize genetic alterations in NGRn BPH.ResultsTwo hundred and two nonbenign, ClinVar‐annotated germline variants were present in NGRn BPH samples. Six genes [BRCA1 (92%), HSD3B1 (85%), TP53 (37%), PMS2 (23%), BARD1 (20%), and BRCA2 (17%)] were altered in at least 10% of samples; however, compared to NGRn normal and tumor, the frequency of alterations in BPH samples showed no significant differences at the gene or variant level. BRCA2_rs11571831 and TP53_rs1042522 germline alterations had a statistically significant co‐occurrence interaction in BPH samples. In at least two BPH samples, 173 genes harbored somatic variants known to be clinically actionable. Three genes (COL18A1, KIF16B, and LRP1) showed a statistically significant (p < 0.05) higher frequency in BPH. NGRn BPH also had five gene pairs (PKD1/KIAA0100, PKHD1/PKD1, DNAH9/LRP1B, NWD1/DCHS2, and TCERG1/LMTK2) with statistically significant co‐occurring interactions. Two hundred and seventy‐nine genes contained novel somatic variants in NGRn BPH. Three genes (CABP1, FKBP1C, and RP11‐595B24.2) had a statistically significant (p < 0.05) higher alteration frequency in NGRn BPH and three were significantly higher in NGRn tumor (CACNA1A, DMKN, and CACNA2D2). Pairwise Fisher's exact tests showed 14 gene pairs with statistically significant (p < 0.05) interactions and four interactions approaching significance (p < 0.10). Mutational patterns in NGRn BPH were similar to COSMIC (Catalog of Somatic Mutations in Cancer) signatures associated with aging and dysfunctional DNA damage repair.ConclusionsNGRn BPH contained significant germline alteration interactions (BRCA2_rs11571831 and TP53_rs1042522) and increased somatic alteration frequencies (LMTK2, LRP1, COL18A1, CABP1, and FKBP1C) that impact apoptosis. Normal prostate development is maintained by balancing apoptotic and proliferative activity. Dysfunction in either mechanism can lead to abnormal prostate growth. This work is the first to examine genomic sequencing in NGRn BPH and provides data that fill known gaps in the understanding BPH and how it impacts men of African ancestry.