Factors associated with the use of immune checkpoint inhibitors in older adults with metastatic non-small cell lung cancer and pre-existing autoimmune disease: A SEER-Medicare study
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View abstract on PubMed
Summary
This summary is machine-generated.Older adults with metastatic non-small cell lung cancer and pre-existing autoimmune disease are more likely to receive immune checkpoint inhibitors based on age, region, and diagnosis year. Recent immunosuppressant use was associated with lower ICI utilization.
Area Of Science
- Oncology
- Immunology
- Health Services Research
Background
- Pre-existing autoimmune disease (PAD) complicates immune checkpoint inhibitor (ICI) use in metastatic non-small cell lung cancer (mNSCLC).
- Understanding factors influencing ICI treatment decisions in elderly mNSCLC patients with PAD is crucial for optimizing care.
Purpose Of The Study
- To investigate factors associated with the utilization of immune checkpoint inhibitors (ICIs) versus chemotherapy in older adults (≥66 years) with metastatic non-small cell lung cancer (mNSCLC) and pre-existing autoimmune disease (PAD).
Main Methods
- Retrospective cohort study using SEER-Medicare data (2015-2017).
- Included patients aged 66+ with mNSCLC initiating first-line immunotherapy/chemoimmunotherapy or chemotherapy, with at least one diagnosed PAD prior to treatment.
- Multivariable logistic regression analyzed factors influencing treatment selection, reporting adjusted odds ratios (aORs).
Main Results
- Of 1,319 patients, 22.3% received immunotherapy/chemoimmunotherapy (IT/CIT).
- IT/CIT utilization was higher in older age groups (76-80 and >80 years), specific SEER regions (South, West), later diagnosis years (2016, 2017), longer time to treatment, non-squamous histology, and prior hospitalization.
- Recent immunosuppressant (IS) use was significantly associated with lower IT/CIT use (aOR=0.06).
Conclusions
- Age, geographic region, diagnosis year, time to treatment, tumor histology, prior hospitalization, and recent immunosuppressant use are key factors influencing ICI selection in elderly mNSCLC patients with PAD.
- Further research is needed to optimize treatment strategies for this specific patient population.
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