Racial disparities in treatment patterns in patients with non-small cell lung cancer before and after approval of immune checkpoint inhibitors: A population-based study
Ashwini Arunachalam, Soko Setoguchi, Jason Roy, Jyoti Malhotra, Judith M. GraberBackground
The introduction of immune checkpoint inhibitors (ICIs) has changed the treatment landscape for advanced non-small cell lung cancer (NSCLC). This study investigates racial disparities in the receipt of systemic therapy among patients with advanced NSCLC in periods before and after approval of ICIs.
Methods
This retrospective cohort study analyzed data on patients with advanced NSCLC, comparing patient characteristics and systemic therapy receipt before and after the introduction of ICIs. The study population included White, Black, and Asian patients. We used logistic regression to calculate crude and adjusted odds ratios (ORs) for the initiation of guideline-recommended systemic therapy.
Results
Systemic therapy use increased for all racial groups in the post-ICI era. However, disparities in the type of treatment and time to initiation persisted. In the pre-ICI period, after adjustment for covariates, Asian patients had higher odds (OR 2.33, 95% CI 1.82–2.98), and Black patients had similar odds (OR 1.06, 95% CI 0.81–1.40) of initiating therapy compared with White patients. In the post-ICI period, there were no statistically significant differences in the adjusted odds of initiating therapy among the racial groups.
Conclusion
The introduction of ICIs was associated with an overall increase in the receipt of systemic therapy for advanced NSCLC and a reduction in racial disparities in the treatment initiation. However, differences in the types of therapy received and time to treatment initiation remain.