Racial Disparities in Immune Checkpoint Inhibitor Treatment and Survival Among Patients With NSCLC
An analysis of patients with metastatic non-small cell lung cancer (NSCLC) shows disparities in immune checkpoint inhibitor utilization and survival based on race and socioeconomic factors, highlighting the need for improved access to care for vulnerable populations.
“Historically, there have been significant racial disparities in receiving recommended treatment for patients with NSCLC,” researchers said. “In this study, we sought to evaluate racial differences in immune checkpoint inhibitor treatment and corresponding survival of patients with metastatic NSCLC in the immunotherapy era utilizing the SEER-Medicare database.”
The study focused on elderly patients diagnosed with metastatic NSCLC between 2015 and 2019 who were enrolled in Medicare parts A, B, and D until December 2020. The main outcome of interest was receipt of immune checkpoint inhibitors, with survival data obtained from Medicare enrollment files and analyzed using Kaplan-Meier curves and logistic regression.
Of the 17 134 patients studied, around 39% were treated with an immune checkpoint inhibitor. Factors that increased the likelihood of receiving this treatment included recent cancer diagnosis, younger age, specific racial backgrounds, higher socioeconomic status, and adenocarcinoma histology. The 2-year survival rate from diagnosis was 21% for all patients, 30% for those who received immune checkpoint inhibitors, and 11% for those who did not. Non-Hispanic White and non-Hispanic Asian patients had higher survival rates compared with non-Hispanic Black and Hispanic patients, with no significant racial differences observed among those who received immune checkpoint inhibitors.
“Immune checkpoint inhibitor utilization rates and the resulting outcomes were inferior for certain vulnerable groups, mandating the need for strategies to improve access to care,” researchers said.
Reference
Uprety D, Seaton R, Hadid T, et al. Racial and socioeconomic disparities in survival among patients with metastatic non–small cell lung cancer. J Natl Cancer InstI. 2024;116(10):1697–1704. doi:10.1093/jnci/djae118
