Clinical efficacy of frontline immunotherapy (IO) in ethnic-minority patients (pts) with metastatic NSCLC.

person Matthew Lee Montefiore-Einstein Cancer Center, The Bronx, NY info_outline Matthew Lee, Jianyou Liu, Emily Miao, Shuai Wang, Frank Zhang, John X Wei, Julie Chung, Xiaonan Xue, Balazs Halmos, Dean Hosgood, Haiying Cheng

Authors person Matthew Lee Montefiore-Einstein Cancer Center, The Bronx, NY info_outline Matthew Lee, Jianyou Liu, Emily Miao, Shuai Wang, Frank Zhang, John X Wei, Julie Chung, Xiaonan Xue, Balazs Halmos, Dean Hosgood, Haiying Cheng Organizations Montefiore-Einstein Cancer Center, The Bronx, NY, Albert Einstein College of Medicine, Department of Epidemiology and Population Heath, Bronx, NY, Albert Einstein College of Medicine, Bronx, NY, Montefiore Einstein Center for Cancer Care, Bronx, NY, Montefiore Medical Center, Bronx, NY, Department of Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, New York, NY, Department of Health Information Management, Montefiore Medical Center, Bronx, NY, Montefiore Einstein Cancer Center, Bronx, NY Abstract Disclosures Research Funding No funding received Background: Since minority pts have been historically underrepresented in key IO trials, knowledge on the clinical use of IO in ethnic-minority pts with non-small cell lung cancer (NSCLC) remains limited. This study aims to evaluate race/ethnicity and other demographic, socioeconomic and clinical factors of pts with metastatic NSCLC treated with first-line IO. Methods: A retrospective cohort study of 5920 pts diagnosed with lung cancer within the Montefiore Health system from 1/1/2013 to 6/1/2022 was conducted. Pts with metastatic NSCLC without EGFR or ALK alterations and underwent first-line IO use were identified. The primary endpoint was overall survival (OS) with secondary endpoints of progression-free survival (PFS) and time to discontinuation (TTD) from the start of IO. Results: In total, 248 pts were identified with median follow-up time of 10.7 months (mons), median age of 66 years and 39.1% as Non-Hispanic Black (NHB), 30.2% as Hispanic and 30.7% as non-Hispanic White (NHW). OS (p = 0.39), PFS (p = 0.29) and TTD (p = 0.98) were similar among races/ethnic groups. ECOG < 2 at the start of IO was associated with longer OS summarized in Table 1. Significantly higher PFS and TTD were noted respectively in pts with Medicare insurance and PD-L1 status (TPS>1), while lower PFS and TTD with lower BMI. These results were remained after adjusting for biological sex, smoking status, histology, and IO regimen. Conclusions: Our study demonstrates that race/ethnicity does not impact the benefits of IO. However, factors such as ECOG status impact OS, and BMI, insurance and PD-L1 significantly impact PFS and TTD. These findings help identify potential factors that can be addressed to optimize outcomes and supportive care while undergoing IO. OS (median) (95% CI) P-value PFS (median) (95% CI) P-value TTD (median) (IQR) P-value Age 0.3 0.74 0.29 < 65 22.7(16.7-43) 7.6(5.6-12.7) 5.0(2.1-12) >65 20.7(12.6-31.8) 7.9(6.5-11.9) 4.3(1.4-11) Gender Male 19.7(14-31.8) 0.75 7.8(6.5-12.8) 0.32 4.9(1.9-10.5) 0.91 Female 22.7(15.4-43) 8.2(5.3-11.3) 4.4(1.4-13) Race/Ethnicity Non-Hispanic Black 26.3(14-NA) 0.39 6.7(4.1-9.7) 0.29 4.5(1.4-12.5) 0.98 Hispanic 23.5(13.9-45.7) 7.6(5.6-14.6) 4.9(2.1-11.9) Non-Hispanic White/Others 16.8(12.8-27.7) 4.9(1.7-9.5) Median BMI (range) 23.3 (14.2-65.8) Underweight ( < 18.5) 12.1(8.4-NA) 0.4 6.9(3.2-23) 0.01 3.8(1.8-8.5) 0.02 Healthy (18.5-24.9) 20.2(13.9-31.8) 6.0(5-7.8) 3.7(1.3-8) Overweight (>25) 23.5(16.4-44.7) 11.9(8.2-18.3) 7(2.6-13.6) Insurance Commercial 18.5(13-31.8) 0.15 7.6(5.5-11.3) 0.008 4.9(2.3-9.3) 0.04 Medicare 35.4(19.7-NA) 13.2(7.6-20.4) 5.6(2.1-14) Medicaid 16.4(10.7-29.6) 6(4-7.9) 3.7(1.4-8.5) ECOG < 2 37.2(20.7-NA) < .0001 12.8(8.2-17.1) < .0001 5.9(2.8-13.9) < .0001 >2 9.0(6.3-15.7) 4.6(3.4-7.6) 2.6(0.7-7.3) PDL1 < 1 19.4(10.7-45.7) 0.75 6.5 (5.3-7.3) 0.01 4.3(1.4-9) 0.05 >1 23.0(15.7-38.9) 8.7 (7.6-14.3) 5.1(1.4-11.9)