TY - JOUR
T1 - Similar Efficacy Observed for First-Line Immunotherapy in Racial/Ethnic Minority Patients With Metastatic NSCLC
AU - Lee, Matthew
AU - Liu, Jianyou
AU - Miao, Emily
AU - Wang, Shuai
AU - Zhang, Frank
AU - Wei, John
AU - Chung, Julie
AU - Xue, Xiaonan
AU - Halmos, Balazs
AU - Hosgood, H. Dean
AU - Cheng, Haiying
N1 - Publisher Copyright:
© 2023 Harborside Press. All rights reserved.
PY - 2023/12
Y1 - 2023/12
N2 - Background: Limited data exist on the impact of immunotherapy use in ethnic minority patients with non–small cell lung cancer (NSCLC), because they have been underrepresented in immunotherapy trials. This study aims to evaluate race/ethnicity and other demographic, socioeconomic, and clinical factors of patients with metastatic NSCLC treated with first-line immunotherapy. Methods: A retrospective cohort study of 5,920 patients diagnosed with lung cancer treated at Montefiore Einstein Cancer Center from January 1, 2013, to June 1, 2022, was used to identify patients with metastatic NSCLC without EGFR, ALK, or ROS1 alterations who underwent first-line immunotherapy (n5248). The primary endpoint was overall survival (OS), with secondary endpoints of progression-free survival (PFS) and time to discontinuation (TTD) from the start of immunotherapy. Results: Among the 248 patients, median follow-up time was 12.0 months, median age at start of treatment was 66 years, and 39.1% were non-Hispanic Black, 30.2% were Hispanic, and 30.7% were non-Hispanic White. OS (P 5.39), PFS (P 5.29), and TTD (P 5.98) were similar among racial/ ethnic groups. Patients with an ECOG performance status (PS) of,2 at the start of immunotherapy had longer OS compared with those with ECOG PS of $2 (P,.0001). PD-L1 expression (,50% vs $50%; P 5.03) and body mass index (BMI) (P 5.01) were also found to be associated with PFS, and ECOG PS (P,.0001) and BMI (P 5.02) were associated with TTD. In a multivariate analysis of OS and PFS, ECOG PS was the only variable found to be significant. Conclusions: Our study observed similar benefits of immunotherapy in patients with metastatic NSCLC in different racial and ethnic groups. Furthermore, ECOG PS was associated with OS, and PD-L1 expression and BMI were associated with PFS and TTD. These findings help identify potential factors associated with outcomes and care while patients are undergoing immunotherapy.
AB - Background: Limited data exist on the impact of immunotherapy use in ethnic minority patients with non–small cell lung cancer (NSCLC), because they have been underrepresented in immunotherapy trials. This study aims to evaluate race/ethnicity and other demographic, socioeconomic, and clinical factors of patients with metastatic NSCLC treated with first-line immunotherapy. Methods: A retrospective cohort study of 5,920 patients diagnosed with lung cancer treated at Montefiore Einstein Cancer Center from January 1, 2013, to June 1, 2022, was used to identify patients with metastatic NSCLC without EGFR, ALK, or ROS1 alterations who underwent first-line immunotherapy (n5248). The primary endpoint was overall survival (OS), with secondary endpoints of progression-free survival (PFS) and time to discontinuation (TTD) from the start of immunotherapy. Results: Among the 248 patients, median follow-up time was 12.0 months, median age at start of treatment was 66 years, and 39.1% were non-Hispanic Black, 30.2% were Hispanic, and 30.7% were non-Hispanic White. OS (P 5.39), PFS (P 5.29), and TTD (P 5.98) were similar among racial/ ethnic groups. Patients with an ECOG performance status (PS) of,2 at the start of immunotherapy had longer OS compared with those with ECOG PS of $2 (P,.0001). PD-L1 expression (,50% vs $50%; P 5.03) and body mass index (BMI) (P 5.01) were also found to be associated with PFS, and ECOG PS (P,.0001) and BMI (P 5.02) were associated with TTD. In a multivariate analysis of OS and PFS, ECOG PS was the only variable found to be significant. Conclusions: Our study observed similar benefits of immunotherapy in patients with metastatic NSCLC in different racial and ethnic groups. Furthermore, ECOG PS was associated with OS, and PD-L1 expression and BMI were associated with PFS and TTD. These findings help identify potential factors associated with outcomes and care while patients are undergoing immunotherapy.
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U2 - 10.6004/jnccn.2023.7064
DO - 10.6004/jnccn.2023.7064
M3 - Article
C2 - 38081123
AN - SCOPUS:85179639353
SN - 1540-1405
VL - 21
SP - 1269
EP - 1280
JO - JNCCN Journal of the National Comprehensive Cancer Network
JF - JNCCN Journal of the National Comprehensive Cancer Network
IS - 12
ER -
