1. Disparities in the Use of Programmed Death 1 Immune Checkpoint Inhibitors
- Author
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Paul You, Jeremy M. O’Connor, Kathi Seidl-Rathkopf, Aracelis Z. Torres, Joseph S. Ross, Cary P. Gross, and Kenneth R. Carson
- Subjects
Oncology ,Male ,Cancer Research ,medicine.medical_specialty ,Programmed Cell Death 1 Receptor ,Odds ,03 medical and health sciences ,0302 clinical medicine ,Renal cell carcinoma ,Internal medicine ,medicine ,Humans ,030212 general & internal medicine ,Stage (cooking) ,Healthcare Disparities ,business.industry ,Melanoma ,Odds ratio ,medicine.disease ,Confidence interval ,030220 oncology & carcinogenesis ,Cohort ,Observational study ,Female ,business ,Brief Communications - Abstract
Amid growing excitement for immune checkpoint inhibitors of programmed death protein 1 (anti-PD1 agents), little is known about whether race- or sex-based disparities exist in their use. In this observational study, we constructed a large and mostly community-based cohort of patients with advanced stage cancers, including melanoma, non-small cell lung cancer (NSCLC), and renal cell carcinoma, to compare the odds of receiving systemic treatment with or without anti-PD1 agents by race and by sex. In multivariable models that adjusted for age, stage, and number of prior anticancer therapies, we found no significant race-based disparities in anti-PD1 treatment. However, among patients with NSCLC, males had significantly higher odds of receiving anti-PD1 treatment compared with females (odds ratio 1.13, 95% confidence interval 1.02–1.24, p = .02). This finding suggests that as anti-PD1 agents enter the market to transform patient care, it will be critical to monitor for disparities in the use of these drugs.
- Published
- 2018