Overview
Immunotherapies have revolutionized the management of metastatic non-small cell lung cancer, significantly improving survival for patients without targeted genetic mutations. As a result, national guidelines recommend immunotherapy as the preferred first-line treatment for these individuals, yet a notable portion of eligible patients in real-world settings do not receive it.
Researchers analyzed the Flatiron Health Research Database to evaluate 13,223 patients with metastatic lung cancer who were ineligible for targeted therapies and started first-line treatment between 2019 and 2023. The study revealed that 25% of patients received treatment without immunotherapy—a rate that remained unchanged over the four-year period. Based on this analysis, differences in treatment selection may be driven by demographic and clinical characteristics including but not limited to age, stage at initial diagnosis, PD-L1 staining status at the time of 1L therapy assignment, and prior PD-(L)1 usage.
Why this matters
This study exposes persistent, real-world disparities in access to standard-of-care lung cancer treatments. By identifying the clinical and structural barriers that prevent one in four eligible patients from receiving life-extending immunotherapies, this research highlights critical targets for focused interventions to ensure equitable cancer care for all.