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Sociodemographic disparities in targeted therapy in ovarian cancer in a national sample
Saber A Amin1,2, Lindsay J Collin3, Juraj Kavecansky4
1Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, United States.
Background:
The treatment landscape for ovarian cancer has changed in recent years with the introduction of targeted therapies to treat patients with advanced disease. We investigated patient demographic and clinical factors associated with use of targeted therapies as a part of the first-line treatment for ovarian cancer.
Methods:
This study included patients diagnosed with stage I-IV ovarian cancer between 2012 and 2019 from the National Cancer Database. Information on demographic and clinical characteristics were collected and described using frequency and percent across receipt of targeted therapy. Logistic regression was used to compute the odds ratios (ORs) and 95% confidence intervals (CI) associating patient demographic and clinical factors with receipt of targeted therapy.
Results:
Among 99,286 ovarian cancer patients (mean age 62 years), 4.1% received targeted therapy. The rate of targeted therapy receipt across racial and ethnic groups over the study period was fairly similar; however, non-Hispanic Black women were less likely to receive targeted therapy than their non-Hispanic White counterparts (OR=0.87, 95% CI: 0.76-1.00). Patients who received neoadjuvant chemotherapy were more likely to receive targeted therapy than those who received adjuvant chemotherapy (OR=1.26; 95% CI: 1.15-1.38). Moreover, among patients who received targeted therapy, 28% received neoadjuvant targeted therapy, with non-Hispanic Black women being most likely to receive neoadjuvant targeted therapy (34%) compared with other racial and ethnic groups.
Conclusions:
We observed differences in receipt of targeted therapy by factors such as age at diagnosis, stage, and comorbidities present at diagnosis, as well as factors related to healthcare access-including neighborhood education level and health insurance status. Approximately 28% of patients received targeted therapy in the neoadjuvant setting, which could negatively impact treatment outcomes and survival due to the increased risk of complications associated with targeted therapies that may delay or prevent surgery. These results warrant further evaluation in a cohort of patients with more comprehensive treatment information.
Insights
Targeted therapies are increasingly used in first-line ovarian cancer treatment. However, disparities exist, with non-Hispanic Black women less likely to receive these advanced treatments, highlighting a need for equitable access.
Area of Science:
- Oncology
- Clinical Research
- Health Disparities
Background:
- The treatment of advanced ovarian cancer has evolved with the integration of targeted therapies.
- Understanding factors influencing the use of these novel treatments in first-line care is crucial.
Purpose of the Study:
- To investigate demographic and clinical factors associated with the utilization of targeted therapies in the initial treatment of ovarian cancer.
- To identify potential disparities in access to first-line targeted therapy for ovarian cancer patients.
Main Methods:
- Analysis of data from the National Cancer Database for patients diagnosed with stage I-IV ovarian cancer between 2012 and 2019.
- Descriptive statistics and logistic regression were employed to assess associations between patient characteristics and receipt of targeted therapy.
Main Results:
- Of 99,286 patients, 4.1% received targeted therapy. Non-Hispanic Black women showed lower likelihood of receiving targeted therapy compared to non-Hispanic White women (OR=0.87).
- Patients receiving neoadjuvant chemotherapy were more likely to receive targeted therapy (OR=1.26). Approximately 28% of targeted therapy recipients received it in the neoadjuvant setting.
- Receipt of targeted therapy varied by age, stage, comorbidities, insurance status, and neighborhood education level.
Conclusions:
- Significant differences in targeted therapy receipt were observed based on patient demographics, clinical factors, and healthcare access indicators.
- The high proportion of neoadjuvant targeted therapy raises concerns about potential impacts on surgical timing and treatment outcomes.
- Further research with comprehensive treatment data is needed to fully understand the implications of these findings.
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