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Gregory J. Riely, MD, PhD


Is First-Line Immunotherapy Efficacy Impacted by Race or Ethnicity in Advanced NSCLC?

By: Kayci Reyer
Posted: Thursday, February 1, 2024

According to findings presented in JNCCN–Journal of the National Comprehensive Cancer Network, similar benefits of first-line immunotherapy were observed across racial and ethnic groups in patients with metastatic non–small cell lung cancer (NSCLC). The single-center study included patients who self-identified as Hispanic, non-Hispanic Black, or non-Hispanic White.

“Despite the advances in immunotherapy for patients with NSCLC, the lack of inclusion of a more diverse group of patients in clinical trials has created a gap in knowledge about the impact of health-care disparities and race/ethnicity,” noted Matthew Lee, MD, MPH, of Montefiore Einstein Cancer Center, New York, and colleagues. “This study is one of the first that incorporates ethnic minorities as the majority of the patient population and demonstrates that despite significant differences in socioeconomic factors such as income and insurance, race/ethnicity may not impact the benefits of immunotherapy.”

The retrospective cohort study included 248 patients who underwent first-line immunotherapy for metastatic NSCLC at Montefiore Einstein Cancer Center between January 2013 and June 2022. Participants tested negative for EGFR, ALK, or ROS1 alterations. Patients identifying as non-Hispanic Black, non-Hispanic White, or Hispanic constituted 39.1%, 30.7%, and 30.2% of the cohort, respectively. At a median follow-up of 12 months, overall survival (P = .39), progression-free survival (P = .29), and time to treatment discontinuation (P = .98) were comparable across racial groups.

Patient characteristics other than race were observed to be associated with survival outcomes. For instance, overall survival was longer for patients whose Eastern Cooperative Oncology Group (ECOG) performance status was less than 2 at the time of treatment initiation. Associations with progression-free survival were noted in PD-L1 expression (< 50% vs ≥ 50%; P = .03) and body mass index (BMI; P = .01). ECOG performance status and BMI were also associated with time to treatment discontinuation.

Disclosure: For full disclosures of the study authors, visit

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