PO.CL09.03 · 临床研究
Real-world (RW) outcomes by race in patients (pts) receiving first-line (1L) treatment (tx) for advanced/metastatic (a/m) gastric, gastroesophageal junction, or esophageal adenocarcinoma (GC/GEJC/EAC)
作者与单位
摘要 Abstract
Prior studies show racial disparities in tx access and mortality in GC/GEJC/EAC, yet the effect of race on 1L tx outcomes is unclear. We evaluated tx patterns and outcomes by race in pts who received 1L tx for GC/GEJC/EAC in the US. This retrospective, observational study used the Flatiron Health Research Database. Adults starting 1L tx between May 1, 2021, and Nov 30, 2024 for HER2-negative/unknown GC/GEJC/EAC were included. End of follow-up was May 31, 2025 to allow for ≥6 months of follow-up. Flatiron categorized self-reported race as White, Black/African American (Black), Asian, or other (multiple categories/not listed). RW overall survival (OS), time to next tx/death (TTNTD), and time to tx discontinuation (TTD) were estimated via the Kaplan-Meier method and compared between race categories. Of 2128 eligible pts, 61% were White, 8% Black, 3% Asian, 8% other, and 20% unknown race. Most were treated in community-based oncology practices (77%-79%). Median age was similar across racial groups (69 years); 25% (White), 76% (Black), and 77% (Asian) of pts had GC. Median OS (12.0 vs 13.0 months) and TTNTD (7.6 vs 6.7 months) were similar in Black vs White pts; median TTD was numerically longer in Black vs White pts (4.3 vs 2.3 months). However, the differences in clinical outcomes between Black and White pts were not statistically significant (hazard ratio [95% confidence interval]: OS, 0.97 [0.78-1.20]; TTNTD, 0.93 [0.77-1.13]; TTD, 0.92 [0.76-1.10]) after adjusting for key baseline confounders (Table). These findings underscore the potential impact of equitable 1L tx access in minimizing racial disparities in pts with HER2-negative/unknown a/m GC/GEJC/EAC. Larger studies are needed to assess the influence of disease prognosis and other variables, but this study highlights the value of RW data in advancing health equity and guiding future clinical interventions.
Table. Clinical outcomes by race a Median (HR vs White; 95% CI), mo White (n = 1290) Black/African American (n = 174) Asian (n = 68) Other (n = 170) rwOS 13.0 (Referent) 12.0 (0.97; 0.78-1.20) 16.6 (0.88; 0.60-1.27) 13.0 (0.90; 0.72-1.12) rwTTNTD 6.7 (Referent) 7.6 (0.93; 0.77-1.13) 8.6 (0.87; 0.63-1.20) 7.4 (0.95; 0.78-1.16) rwTTD 2.3 (Referent) 4.3 (0.92; 0.76-1.10) 5.0 (0.79; 0.59-1.07) 4.5 (0.81; 0.67-0.98) HR, hazard ratio; mo, months; rwOS, real-world overall survival; rwTTD, real-world time to treatment discontinuation; rwTTNTD, real-world time to next treatment or death. a Analysis excluded pts with unknown race.
利益披露 Disclosure
J. Gu,
Gilead Sciences Employment, Stock.
R. Gupta,
Gilead Sciences Employment.
D. O. Koralek,
Gilead Sciences Employment, Stock.
A. Taylor,
Gilead Sciences Employment, Stock.
J. A. Ajani,
Amgen ), Other, Consulting fees; Honoraria for lectures, Speakers Bureaus, manuscript writing, or educational events; and Participation on a Data Safety Monitoring Board or Advisory Board.
Bristol-Myers Squibb ), Other, Consulting fees; Honoraria for lectures, Speakers Bureaus, manuscript writing, or educational events; and Participation on a Data Safety Monitoring Board or Advisory Board.
Genentech, MedImmune ).
Lilly/ImClone ), Other, Consulting fees; Honoraria for lectures, Speakers Bureaus, manuscript writing, or educational events.
BeiGene Other, Honoraria for lectures, Speakers Bureaus, manuscript writing, or educational events; Participation on a Data Safety Monitoring Board or Advisory Board.
Merck ), Other, Consulting fees; Honoraria for lectures, Speakers Bureaus, manuscript writing, or educational events; and Participation on a Data Safety Monitoring Board or Advisory Board.
Roche/Genentech ), Other, Consulting fees.
Taiho Pharmaceutical ), Other, Consulting fees.
Astellas Pharma Other, Consulting fees; Honoraria for lectures, Speakers Bureaus, manuscript writing, or educational events; and Participation on a Data Safety Monitoring Board or Advisory Board.
AstraZeneca Other, Consulting fees; Honoraria for lectures, Speakers Bureaus, manuscript writing, or educational events.
Daiichi Sankyo Other, Consulting fees; Honoraria for lectures, Speakers Bureaus, manuscript writing, or educational events.
Delta-Fly Pharma, ProLynx, Takeda Other, Consulting fees.
Gilead Sciences Other, Consulting fees; Honoraria for lectures, Speakers Bureaus, manuscript writing, or educational events; and Participation on a Data Safety Monitoring Board or Advisory Board.
Novartis Other, Consulting fees; Honoraria for lectures, Speakers Bureaus, manuscript writing, or educational events; and Participation on a Data Safety Monitoring Board or Advisory Board.
SERVIER Other, Consulting fees; Honoraria for lectures, Speakers Bureaus, manuscript writing, or educational events; and Participation on a Data Safety Monitoring Board or Advisory Board.
Boehringer Ingelheim, DAVA Pharmaceuticals, Fresenius Kabi, GRAIL, Oncotherics Other, Honoraria for lectures, Speakers Bureaus, manuscript writing, or educational events.
American Cancer Society, Geneos, Jazz Pharmaceuticals, Kyowa Kirin International, Vaccinogen Other, Participation on a Data Safety Monitoring Board or Advisory Board.
Zymeworks Other, Consulting fees; Honoraria for lectures, Speakers Bureaus, manuscript writing, or educational events; and Participation on a Data Safety Monitoring Board or Advisory Board.
Aduro Biotech Other, Honoraria for lectures, Speakers Bureaus, manuscript writing, or educational events.
Acrotech Biopharma Other, Honoraria for lectures, Speakers Bureaus, manuscript writing, or educational events.