Guideline-concordant osimertinib and durvalumab in two US non-small cell lung cancer cohorts. In this study, researchers assessed rates of guideline-concordant care (GCC) with osimertinib and durvalumab among patients with nonmetastatic non-small cell lung cancer (NSCLC). Two cohorts from the Flatiron Health Research Database were analyzed. Patients were aged 18 years or older and treated at a community oncology center. Cohort A consisted of patients with resected stage II to IIIA EGFR-mutant NSCLC who were diagnosed from December 2020 to April 2024, and Cohort B consisted of patients with unresectable stage III NSCLC treated with definitive chemotherapy who were diagnosed from November 2018 to April 2024. Of 378 patients in Cohort A, 265 (70%) received adjuvant osimertinib treatment. Consolidative durvalumab was administered to 6,295 of 9,307 patients (68%) in Cohort B; thus, 30% of patients in Cohort A and 32% in Cohort B did not receive GCC. Multivariable analysis showed that in Cohort A, patients who received guideline-concordant osimertinib were more likely to be Latinx vs non-Latinx/White (adjusted odds ratio [aOR]: 5.72; 95% confidence interval [CI]: 1.18–50.9) and a never smoker vs an ever smoker (aOR: 2.69; 95% CI: 1.55–4.8). Being diagnosed in 2024 (vs prior to 2022) was associated with lower odds of GCC receipt (aOR: 0.39; 95% CI: 0.16–0.91). In Cohort B, characteristics associated with lower odds of receiving guideline-concordant durvalumab included age of ≥80 years at diagnosis (vs <50 years; aOR: 0.62; 95% CI: 0.41–0.93) and male sex (vs female sex; aOR: 0.91; 95% CI: 0.83–0.99). Diagnosis in 2024 vs 2018 was associated with higher odds of receipt of GCC (aOR: 1.39; 95% CI: 1.12–1.72).
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Cancer-related distress and unmet needs among those with metastatic and nonmetastatic non-small cell lung cancer: findings from the Cancer Experience Registry. Here, researchers aimed to describe cancer-related distress among patients with NSCLC, as well as determine factors associated with cancer-related distress. A total of 279 patients completed the Cancer Experience Registry® online survey from February 2015 to November 2023. Distress was measured with the 25-item CancerSupportSource™ (CSS) across 5 domains (emotional well-being [EWB]; symptom burden and impact [SYM]; body image and healthy lifestyle [BHL]; healthcare team communication [HTC]; relationships and intimacy [REL]). Most respondents were women (68%) and non-Hispanic White (88%). Mean age was 64 years. Fifty-six percent of patients had metastatic disease, and 40% were on treatment when they completed the survey. Across the domains, distress was highest for BHL (1.26), followed by EWB (1.23), REL (1.20), SYM (1.07), and HCT (0.83). Distress across domains did not significantly differ based on metastatic status. Future uncertainty, fatigue, and physical activity were primary concerns for both metastatic and nonmetastatic patients. For metastatic patients, finances were also a top concern, and reported worry about family, friends, and romantic partners was significantly higher. For nonmetastatic patients, eating/nutrition was a primary concern, and concern about daily mobility was significantly greater. Younger age was associated with greater BHL, EWB, REL, and overall distress upon multivariable analysis. Women reported greater worry related to BHL, EWB, SYM, and overall distress compared to men. Distress in all domains was lower for patients who were employed or retired, compared to patients who were unemployed due to disability.
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Federal housing assistance and treatment receipt for non-small cell lung cancer patients in the US. Researchers analyzed data from the Surveillance, Epidemiology, and End Results (SEER)-Medicare Housing and Urban Development database to explore the association between federal housing assistance and receipt of cancer treatment among patients with NSCLC. Eligible patients were aged 66 to 95 years, had newly diagnosed NSCLC between 2007 and 2019, and survived for at least 3 months after diagnosis. Federal housing assistance was defined as continuous enrollment in any housing program from 6 months before to 3 months after NSCLC diagnosis. A total of 3,836 patients with housing assistance and 11,508 matched controls were included for analysis. There were no significant differences in treatment patterns between patients with and without housing assistance across treatment types and stage. Within 3 months of diagnosis, 39.1% of stage I patients with housing assistance and 34.8% of those without housing assistance underwent surgery, and 10.1% and 8.9%, respectively, received chemotherapy. About 40% of patients with stage III/IV disease in both groups received chemotherapy. Among patients with stage IV disease with and without housing assistance, 13.8% and 12.7%, respectively, received immunotherapy. Median time to first treatment initiation was about 44 days for patients with stage II NSCLC and 48 days for those with stage IV disease, and this did not significantly differ between patients with and without housing assistance.
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Survival disparities in non-small cell lung cancer: disaggregating Asians from NHPI and identifying variability among common Asian subgroups—the largest single-center study in Hawai’i. In this retrospective cohort study, researchers evaluated survival outcomes in Asian and Native Hawaiian/Pacific Islander (NHPI) patients with NSCLC. Single-center data from 2000 to 2022 were analyzed. A total of 4,160 patients were included for analysis, and patients were categorized into 6 racial/ethnic groups: Chinese (n=419), Filipino (n=724), Japanese (n=968), Other Asian (n=217), NHPI (n=855), and White (n=977). Median OS was longest in Chinese patients (22.3 months), followed by White (20.9 months), Filipino (19.7 months), Japanese (17.7 months), and NHPI (14.7 months) patients (P<0.001). Compared to White patients, Asian patients had a significantly reduced risk of death (adjusted hazard ratio [aHR]: 0.89; 95% CI: 0.85–0.97; P=0.010), while NHPI patients had a significantly greater risk of death (aHR: 1.15; 95% CI: 1.03–1.28; P=0.011) in multivariable analysis. However, after adjusting for treatment, neither measure retained significance (Asian vs White, aHR: 0.93; 95% CI: 0.85–1.01; P=0.093; NHPI vs White, aHR: 1.06; 95% CI: 0.95–1.18; P=0.313). According to subgroup analyses, Chinese patients experienced the lowest risk of death compared to White patients (aHR: 0.82; 95% CI: 0.72–0.93; P=0.003).
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Influence of social determinants of health (SDoH) on metastatic non-small cell lung cancer (mNSCLC) testing in the community setting. The aim of this study was to determine the effect of social determinants of health (SDoH) on next-generation sequencing (NGS) and programmed death-ligand 1 (PD-L1) testing in patients with metastatic NSCLC in the community setting. Data from January 2020 to April 2024 from adult patients with adenocarcinoma histology ≥30 days between diagnosis date and last clinical activity were analyzed. Among 1,000 patients, 51.2% were female, 75.9% were White, and 64.2% received an initial diagnosis of metastatic disease. In total, 567 underwent both NGS and PD-L1 testing, 204 underwent NGS only, 167 underwent PD-L1 testing only, and 62 underwent no biomarker testing. The percentage of missing data ranged from 1.6% to 55.2%. The likelihood of receiving both NGS and PD-L1 testing was significantly lower for patients diagnosed with stage I to IIIA disease (aOR: 0.20; P<0.0001) or stage IIIB/C disease (aOR: 0.20; P=0.0023) compared to patients diagnosed with stage IV disease; likelihood of receiving NGS testing only was also significantly lower in patients with earlier-stage disease vs those with stage IV disease at diagnosis (stage I–IIIA, aOR: 0.15; P<0.0001; stage IIIB/C, aOR: 0.13; P=0.009). Older age was significantly associated with decreased odds of receiving only PD-L1 testing compared to no testing (OR: 0.85). Diagnosis after 2020 was associated with higher odds of receiving NGS testing only vs no biomarker testing (OR: 1.71).
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