L-SOLCO Pilot Study: Examining Allostatic Load and Cancer Treatment Disparities

BACKGROUND: Cancer treatment disparities persist among low-income and underrepresented populations, with chronic stress and cumulative disadvantage increasingly linked to these disparities. Allostatic load, the physiological dysregulation due to repeated stress exposure—has been implicated in cancer incidence and outcomes, but its impact on treatment tolerance remains unclear. Because the first treatment for lung cancer is the most highly efficacious, the ability to withstand the first cancer treatment is the most critically important. OBJECTIVE: The Longitudinal Study of Symptom Experience, Management Outcomes, and Adherence in Cancer (L-SOLCO) aims to explore how lifetime stress, perceived discrimination, and allostatic load contributes to disparities in lung cancer treatment tolerance and outcomes. METHODS: The study will enroll 30 patients with advanced-stage non-small cell lung cancer prior to, or during first treatment. Data will include patient surveys, biological markers, medical record abstraction, and qualitative interviews. This pilot study will establish feasibility and generate preliminary data regarding lifetime stress, social determinants of health and allostatic load and their contribution to cancer treatment disparities. Outcomes will include feasibility, participant engagement, retention, and baseline and longitudinal data on stress exposure, symptom burden, and chemotherapy dose modifications at 3- and 6- months post-enrollment. ANALYSIS: Quantitative data will be analyzed using descriptive, comparative and correlative analyses to assess feasibility and disparities in cancer outcomes. Thematic analysis of qualitative interviews will identify barriers to care. RESULTS AND SIGNIFICANCE: This pilot study will establish feasibility and generate preliminary data regarding measuring lifetime stress, social determinants of health and allostatic load and their contribution to cancer treatment disparities. Potentially, findings will inform interventions to improve treatment adherence and outcomes among highly stressed, disadvantaged populations. CONCLUSION: L-SOLCO will enhance understanding of the interplay between stress, biological aging, and cancer care disparities, providing a foundation for large-scale studies and equitable treatment strategies. Potentially, findings will inform interventions to improve treatment adherence and outcomes among disadvantaged populations.