Biomarker Testing, Targeted Therapy and Clinical Trial Participation by Race Among Patients With Lung Cancer: A Real-World Medicaid Database Study
Introduction: Biomarker testing in oncology is fundamental for targeted therapy use and clinical trial participation. Factors contributing to previously identified racial disparities in biomarker testing remain unclear. This study investigated biomarker testing, clinical trial participation, and tar...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-03-01
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| Series: | JTO Clinical and Research Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666364324000134 |
| _version_ | 1827311748677369856 |
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| author | Debora S. Bruno, MD, MS Xiaohong Li, MPH Lisa M. Hess, PhD |
| author_facet | Debora S. Bruno, MD, MS Xiaohong Li, MPH Lisa M. Hess, PhD |
| author_sort | Debora S. Bruno, MD, MS |
| collection | DOAJ |
| description | Introduction: Biomarker testing in oncology is fundamental for targeted therapy use and clinical trial participation. Factors contributing to previously identified racial disparities in biomarker testing remain unclear. This study investigated biomarker testing, clinical trial participation, and targeted therapy by race among patients with metastatic lung cancer with Medicaid coverage in the United States. Methods: The Merative MarketScan Medicaid claims database was used for this study to identify patients diagnosed with having metastatic lung cancer between 2017 and 2019 with at least 121 days of follow-up. Racial differences in biomarker testing, clinical trial enrollment, and targeted therapy use were analyzed using chi-square/t tests followed by logistic regression for confounding covariates. Results: A total of 3845 patients were eligible. A total of 970 (25.2%) patients included in this study were Black. Biomarker testing was observed among 57.0%, targeted therapy among 4.6%, and 2.6% of the study cohort had evidence of clinical trial participation. No significant disparities between Black and White races were identified. Younger age and metastatic disease at initial diagnosis were the strongest independent factors associated with increased biomarker testing. Biomarker testing was positively associated with targeted therapy use (OR = 1.69, p = 0.005). Conclusions: Patients with metastatic lung cancer with Medicaid coverage were found to have exceedingly low biomarker testing rates; only 57% had evidence of any biomarker testing. Although no consistent differences between Black and White races were identified, this study calls attention to care experienced by socioeconomically disadvantaged patients with metastatic lung cancer in the United States. |
| first_indexed | 2024-04-24T20:25:03Z |
| format | Article |
| id | doaj.art-a8845350d9c14bc2864dbde968b3f501 |
| institution | Directory Open Access Journal |
| issn | 2666-3643 |
| language | English |
| last_indexed | 2024-04-24T20:25:03Z |
| publishDate | 2024-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JTO Clinical and Research Reports |
| spelling | doaj.art-a8845350d9c14bc2864dbde968b3f5012024-03-22T05:40:43ZengElsevierJTO Clinical and Research Reports2666-36432024-03-0153100643Biomarker Testing, Targeted Therapy and Clinical Trial Participation by Race Among Patients With Lung Cancer: A Real-World Medicaid Database StudyDebora S. Bruno, MD, MS0Xiaohong Li, MPH1Lisa M. Hess, PhD2University Hospitals Cleveland Medical Center, Case Comprehensive Cancer Center, Cleveland, Ohio; Corresponding author. Address for correspondence: Debora S. Bruno, MD, MS, University Hospitals Cleveland Medical Center, Case Comprehensive Cancer Center, Cleveland, OH.Eli Lilly and Company, Indianapolis, IndianaEli Lilly and Company, Indianapolis, IndianaIntroduction: Biomarker testing in oncology is fundamental for targeted therapy use and clinical trial participation. Factors contributing to previously identified racial disparities in biomarker testing remain unclear. This study investigated biomarker testing, clinical trial participation, and targeted therapy by race among patients with metastatic lung cancer with Medicaid coverage in the United States. Methods: The Merative MarketScan Medicaid claims database was used for this study to identify patients diagnosed with having metastatic lung cancer between 2017 and 2019 with at least 121 days of follow-up. Racial differences in biomarker testing, clinical trial enrollment, and targeted therapy use were analyzed using chi-square/t tests followed by logistic regression for confounding covariates. Results: A total of 3845 patients were eligible. A total of 970 (25.2%) patients included in this study were Black. Biomarker testing was observed among 57.0%, targeted therapy among 4.6%, and 2.6% of the study cohort had evidence of clinical trial participation. No significant disparities between Black and White races were identified. Younger age and metastatic disease at initial diagnosis were the strongest independent factors associated with increased biomarker testing. Biomarker testing was positively associated with targeted therapy use (OR = 1.69, p = 0.005). Conclusions: Patients with metastatic lung cancer with Medicaid coverage were found to have exceedingly low biomarker testing rates; only 57% had evidence of any biomarker testing. Although no consistent differences between Black and White races were identified, this study calls attention to care experienced by socioeconomically disadvantaged patients with metastatic lung cancer in the United States.http://www.sciencedirect.com/science/article/pii/S2666364324000134Biomarker testingReal-world dataHealth care disparitiesTargeted therapyClinical trials |
| spellingShingle | Debora S. Bruno, MD, MS Xiaohong Li, MPH Lisa M. Hess, PhD Biomarker Testing, Targeted Therapy and Clinical Trial Participation by Race Among Patients With Lung Cancer: A Real-World Medicaid Database Study JTO Clinical and Research Reports Biomarker testing Real-world data Health care disparities Targeted therapy Clinical trials |
| title | Biomarker Testing, Targeted Therapy and Clinical Trial Participation by Race Among Patients With Lung Cancer: A Real-World Medicaid Database Study |
| title_full | Biomarker Testing, Targeted Therapy and Clinical Trial Participation by Race Among Patients With Lung Cancer: A Real-World Medicaid Database Study |
| title_fullStr | Biomarker Testing, Targeted Therapy and Clinical Trial Participation by Race Among Patients With Lung Cancer: A Real-World Medicaid Database Study |
| title_full_unstemmed | Biomarker Testing, Targeted Therapy and Clinical Trial Participation by Race Among Patients With Lung Cancer: A Real-World Medicaid Database Study |
| title_short | Biomarker Testing, Targeted Therapy and Clinical Trial Participation by Race Among Patients With Lung Cancer: A Real-World Medicaid Database Study |
| title_sort | biomarker testing targeted therapy and clinical trial participation by race among patients with lung cancer a real world medicaid database study |
| topic | Biomarker testing Real-world data Health care disparities Targeted therapy Clinical trials |
| url | http://www.sciencedirect.com/science/article/pii/S2666364324000134 |
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