Black Patients with NSCLC Less Likely to Participate in Trials, Undergo Biomarker Testing

A retrospective study presented during the 2021 ASCO Annual Meeting described racial disparities among patients with non-small cell lung cancer (NSCLC) in terms of rates of biomarker testing and enrollment in clinical trials.

Researchers queried the Flatiron Health Database for data on patients with advanced/metastatic NSCLC who received systemic therapy between January 1, 2017, and October 30, 2020. A total of 14,768 eligible patients were identified, of whom 9,793 (66.3%) were white and 1,288 (8.7%) were Black.

Roughly three-quarters of white patients (76.4%) and Black patients (73.6%) underwent at least one single molecular test or comprehensive genomic analysis. However, Black patients were less likely than white patients to undergo next-generation sequencing (NGS; 39.8% vs. 50.1%), and less likely to participate in trials (1.9% vs. 3.9%). Race was significantly associated with biomarker testing and trial participation. This association remained statistically significant in adjusted analyses, the researchers reported.

White and Black patients did not largely differ in receipt of first-line targeted therapy (10.2% vs. 9.2%), but the authors noted that “this summary did not consider biomarker test results.” Among white versus Black patients, the rates of first-line pembrolizumab+carboplatin+pemetrexed were 19.8% and 22.6%, respectively; carboplatin+paclitaxel, 16.5% and 18.6%, respectively; and single-agent pembrolizumab, 14.8% and 11.5%, respectively.