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Updated: May 8, 2026
07:59
Ultra-Fast Amplicon-Based Next-Generation Sequencing in Non-Squamous Non-Small Cell Lung Cancer
Published on: September 8, 2023
Rates of Systemic Treatment for Metastatic Non-Small Cell Lung Cancer Among Older Adults
Adam H Fox1, Ralph C Ward2, Mariam Alexander3
1Division of Pulmonary and Critical Care Medicine, Medical University of South Carolina, Charleston.
JAMA Oncology
|May 7, 2026
Summary
Despite advances in cancer treatment, nearly half of older adults with metastatic non-small cell lung cancer (mNSCLC) do not receive systemic therapy. Treatment rates saw minimal improvement from 2006 to 2021, highlighting a gap in care for mNSCLC patients.
Area of Science:
- Oncology
- Public Health
- Health Services Research
Background:
- Metastatic non-small cell lung cancer (mNSCLC) has high mortality rates, representing about half of all lung cancer cases.
- Recent decades have seen advances in mNSCLC treatments, yet population-level treatment patterns remain poorly understood.
Purpose of the Study:
- To characterize treatment rates and trends in mNSCLC.
- To identify factors associated with receiving systemic treatment for mNSCLC.
Main Methods:
- Population-based study using linked SEER-Medicare data (2006-2021).
- Included patients aged 65+ diagnosed with mNSCLC.
- Analyzed receipt of systemic treatment using competing risk models, considering sociodemographic variables, comorbidity, histology, specialist referral, and biomarker testing.
Main Results:
- Of 254,611 mNSCLC patients, 46.8% received systemic treatment.
- Treatment rates increased minimally between 2006 and 2021.
- Referral to oncology specialists (HR, 2.5) and biomarker testing significantly increased treatment likelihood, while older age (>80) and certain histologic types were associated with lower treatment rates.
Conclusions:
- Nearly half of older adults with mNSCLC do not receive systemic therapy, with minimal improvement over time.
- Factors like specialist referral and biomarker testing are associated with higher treatment rates.
- Opportunities exist to improve mNSCLC treatment delivery and patient outcomes.
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