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Related Concept Videos

Tumor Immunotherapy01:27

Tumor Immunotherapy

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Immunotherapy is a treatment that boosts or manipulates the immune system to fight diseases, including cancer. For instance, by stimulating an immune response through vaccinations against viruses that cause cancers, like hepatitis B virus and human papillomavirus, these diseases can be prevented. Nonetheless, some cancer cells can avoid the immune system due to their rapid mutation and division. The immune response to many cancers involves three phases: elimination, equilibrium, and escape.
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Targeted Cancer Therapies02:57

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The targeted cancer therapies, also known as “molecular targeted therapies,” take advantage of the molecular and genetic differences between the cancer cells and the normal cells. It needs a thorough understanding of the cancer cells to develop drugs that can target specific molecular aspects that drive the growth, progression, and spread of cancer cells without affecting the growth and survival of other normal cells in the body.
There are several types of targeted therapies against...
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Disparities in Utilization of Immune Checkpoint Inhibitor Therapy Among Older Patients With Advanced Non-Small Cell

Danting Yang1, Shama D Karanth2,3, Hyung-Suk Yoon2,3

  • 1Department of Epidemiology, University of Florida College of Public Health and Health Professions, Gainesville, FL.

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Black patients with advanced non-small cell lung cancer (NSCLC) received immune checkpoint inhibitor (ICI) therapy less often than White patients. This highlights racial disparities in cancer care access and treatment.

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Area of Science:

  • Oncology
  • Health Services Research
  • Health Disparities

Background:

  • Significant racial and socioeconomic disparities exist in accessing care for advanced non-small cell lung cancer (aNSCLC) in the United States.
  • Immune checkpoint inhibitors (ICIs) represent a crucial treatment modality for aNSCLC, but their equitable utilization across different patient populations is not well understood.

Purpose of the Study:

  • To investigate the association between race/ethnicity and the utilization of immune checkpoint inhibitor (ICI) therapy among older patients diagnosed with advanced non-small cell lung cancer (aNSCLC).
  • To identify potential disparities in access to novel cancer therapies based on patient demographics.

Main Methods:

  • Retrospective analysis of the SEER-Medicare-linked database for patients aged 66 years or older diagnosed with stage III/IV NSCLC between March 2015 and December 2017.
  • Race/ethnicity was categorized into non-Hispanic (NH)-White, NH-Black, Hispanic, and Other groups.
  • Multivariable logistic regression models were employed to assess the association between race/ethnicity and ICI therapy utilization, with adjustments for potential confounders and effect measure modification analyses by sex, socioeconomic status, and comorbidity.

Main Results:

  • The study included 26,836 patients, with 76.2% identified as NH-White.
  • Overall ICI therapy utilization was 17.8%, but varied by ethnicity: NH-Black (14.1%), Hispanic (16.3%), NH-White (18.4%), and Other (18.5%).
  • NH-Black patients were 15% less likely to receive ICI therapy compared to NH-White patients (adjusted odds ratio, 0.85 [95% CI, 0.75 to 0.96]). The association was modified by comorbidity, sex, and socioeconomic status.

Conclusions:

  • Non-Hispanic Black patients with advanced non-small cell lung cancer were significantly less likely to receive immune checkpoint inhibitor therapy compared to their non-Hispanic White counterparts.
  • These findings underscore persistent racial/ethnic disparities in the utilization of advanced cancer therapies, specifically ICI treatment for aNSCLC.
  • Further targeted interventions are essential to address and mitigate these disparities, aiming to optimize equitable access to potentially life-saving cancer care.