Yale University School of Medicine, New Haven, Connecticut, USA
National Clinician Scholars Program, Yale University School of Medicine, New Haven, Connecticut, USA.
Oncologist. 2018 Nov;23(11):1388-1390. doi: 10.1634/theoncologist.2017-0673. Epub 2018 Jul 16.
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, = .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.
在对程序性死亡蛋白 1(抗 PD1 药物)免疫检查点抑制剂的应用日益兴奋的同时,对于其在使用中是否存在基于种族或性别的差异知之甚少。在这项观察性研究中,我们构建了一个大型的、主要基于社区的晚期癌症患者队列,包括黑色素瘤、非小细胞肺癌(NSCLC)和肾细胞癌,以比较按种族和性别接受系统治疗(有无抗 PD1 药物)的可能性。在调整了年龄、分期和先前抗癌治疗次数的多变量模型中,我们没有发现抗 PD1 治疗存在基于种族的显著差异。然而,在 NSCLC 患者中,男性接受抗 PD1 治疗的可能性显著高于女性(比值比 1.13,95%置信区间 1.02-1.24, = .02)。这一发现表明,随着抗 PD1 药物进入市场改变患者的治疗,监测这些药物使用中的差异将至关重要。