PLYMOUTH MEETING, PA — A groundbreaking study published in the December 2023 issue of JNCCN—Journal of the National Comprehensive Cancer Network, has shed light on the efficacy of immunotherapy in treating advanced Non-Small Cell Lung Cancer (NSCLC) across different racial and ethnic groups. The study found that survival rates, progression-free survival, and treatment duration were similar among patients of diverse races or ethnicities, despite disparities in income and insurance.
The researchers, led by Matthew Lee, MD, MPH, Assistant Professor of Oncology at Montefiore Einstein Comprehensive Cancer Center (MECCC), focused on under-represented groups. These demographics have typically been less likely to participate in clinical trials for immunotherapy. The investigators analyzed results from 248 patients treated with pembrolizumab over a period of nine years, from January 1, 2013, to June 1, 2022. The patient group included non-Hispanic Black, Hispanic, and non-Hispanic White patients, with each ethnicity accounting for approximately an equal percentage. The median overall survival ranged from 16.8 to 26.3 months, mirroring results previously reported in large prospective clinical trials.
Dr. Lee highlighted the significance of these findings in understanding how immunotherapy impacts racially and ethnically marginalized lung cancer patients. “These findings could change how we take care of patients and plan future lung cancer studies to better include all patients. Differences exist in immunotherapy administration among individuals of different races and ethnicities. This finding could potentially promote the use of immunotherapy in more diverse patient populations,” said Dr. Lee.
The study also uncovered some unexpected correlations. Higher BMI was associated with longer progression-free survival and shorter time to treatment discontinuation. Furthermore, a worse ECOG Performance Status—a measure of a patient’s ability to perform daily activities—was significantly more likely to result in poorer outcomes.
Senior researcher Haiying Cheng, MD, PhD, Associate Professor of Oncology and Member of the MECCC Cancer Therapeutics Research Program, emphasized the need for future studies to include underrepresented patient groups in clinical trials. “This study highlights the potential importance of adjusting treatment approaches in clinical practice, particularly for patients with a poor ECOG performance status,” said Dr. Cheng.
The findings have been lauded by other experts in the field, including Dr. Bruno, a Member of the NCCN Guidelines® Panel for Non-Small Cell Lung Cancer/Mesothelioma/Thymomas and Thymic Carcinomas. Dr. Bruno stressed the importance of continuing to strive for equitable representation for all patients in prospective oncology clinical trials.
The full study, titled “Similar Efficacy Observed for First-Line Immunotherapy in Ethnic Minority Patients With Metastatic NSCLC,” is available for complimentary access on JNCCN.org until March 10, 2024.
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