Persistent Ethnicity-Associated Disparity in Anti-Tumor Effectiveness of Immune Checkpoint Inhibitors Despite Equal Access

Authors

Marcus A Florez
Jan O Kemnade
Nan Chen
Wendy Du
Anita L Sabichi
Daniel Y Wang
Quillan Huang
Courtney N Miller-Chism
Aparna Jotwani
Albert C Chen
David Hernandez
Vlad C Sandulache

Publication Date

7-26-2022

Journal

Cancer Research Communications

DOI

10.1158/2767-9764.CRC-21-0143

PMID

35966167

PMCID

PMC9367161

PubMedCentral® Posted Date

8-15-2022

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

Keywords

Humans, Ethnicity, Squamous Cell Carcinoma of Head and Neck, Immune Checkpoint Inhibitors, Retrospective Studies, Head and Neck Neoplasms, Lung Neoplasms

Abstract

We reviewed response to immune checkpoint inhibitors (ICI) of 207 patients with diagnoses of lung or head and neck cancer treated with chemotherapy/ICI combination therapy and ICI monotherapy between 2015 and 2020 at one of three clinical pavilions associated with the Dan L. Duncan Comprehensive Cancer Center at Baylor College of Medicine. Two of these pavilions (Harris Health System and the Michael E. DeBakey Veterans Affairs Medical Center) serve large minority populations and provide equal access to care regardless of means. 174 patients had a diagnosis of lung cancer (non-small cell or small cell) and 33 had a diagnosis of head and neck squamous cell carcinoma (HNSCC). 38% self-identified as Black, 45% as non-Hispanic White, and 18% as Hispanic. The objective response rate (ORR) was similar for lung cancer (35.057%) and HNSCC patients (30.3%) (p=0.894). The ORR for Hispanic and Black patients was lower compared to non-Hispanic White patients (H 27.0%, B 32.5%, W 38.7%; H vs. W p=0.209; B vs. W p=0.398). When considering only patients treated with ICI monotherapy, the ORR for Hispanic patients dropped further to 20.7% while the ORR of Black and non-Hispanic White patients remained about the same (B 29.3% and W 35.9%, H vs. W p=0.133; B vs. W p=0.419). Immune related adverse events were the lowest in the Hispanic population occurring in only 30% of patients compared to 40% of patients in the Black cohort and 50% of the non-Hispanic White cohorts.

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