sábado, 2 de marzo de 2019

Disparities and Trends in Rates of Genetic Testing and Erlotinib Treatment Among Metastatic Non-Small Cell Lung Cancer Patients. - PubMed - NCBI

2019 Feb 20. pii: cebp.0917.2018. doi: 10.1158/1055-9965.EPI-18-0917. [Epub ahead of print]

Disparities and Trends in Rates of Genetic Testing and Erlotinib Treatment Among Metastatic Non-Small Cell Lung Cancer Patients.

Palazzo LL1, Sheehan DF1, Tramontano AC2, Kong CY3.

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Abstract

BACKGROUND:

Despite reports of socioeconomic disparities in rates of genetic testing and targeted therapy treatment for metastatic non-small cell lung cancer (NSCLC), little is known about whether such disparities are changing over time.

METHODS:

We performed a retrospective analysis to identify disparities and trends in genetic testing and treatment with erlotinib. Using the Surveillance, Epidemiology, and End Results (SEER)-Medicare database, we identified 9,900 stage 4 NSCLC patients diagnosed in 2007-2011 at age 65 or older. We performed logistic regression analyses to identify patient factors associated with odds of receiving a genetic test and erlotinib treatment, and to assess trends in these differences with respect to diagnosis year.

RESULTS:

Patients were more likely to receive genetic testing if they were under age 75 at diagnosis (odds ratio [OR]=1.55) independent of comorbidity level, and this age-based gap showed a decrease over time (OR=0.93). For untested patients, erlotinib treatment was associated with race (OR=0.58, black vs. white; OR=2.45, Asian vs. white), and was more likely among female patients (OR=1.45); for tested patients, erlotinib treatment was less likely among low-income patients (OR=0.32). Most of these associations persisted or increased in magnitude.

CONCLUSIONS:

Race and sex are associated with rates of erlotinib treatment for patients who did not receive genetic testing, and low-income status is associated with treatment rates for those who did receive testing. The racial disparity remained stable over time, while the income-based disparity grew larger.