Disparities in metastatic renal cell carcinoma (mRCC) outcomes persist in the era of oral anticancer agents (OAAs) and immunotherapies (IOs). We examined variation in the utilization of mRCC systemic therapies among US Medicare beneficiaries from 2015-2019. Logistic regression models evaluated the association between therapy receipt and demographic covariates including patient race, ethnicity and sex. In total, 15,407 patients met study criteria. After multivariable adjustment, non-Hispanic Black race and ethnicity was associated with reduced IO (adjusted relative risk ratio (aRRR) = 0.76 [0.61-0.95]; P = 0.015) and OAA receipt (aRRR = 0.76 [0.64-0.90]; P = 0.002) compared to non-Hispanic White race and ethnicity. Female sex was associated with reduced IO (aRRR = 0.73 [0.66-0.81]; P < 0.001) and OAA receipt (aRRR = 0.74 [0.68-0.81]; P < 0.001) compared to male sex. Thus, disparities by race, ethnicity, and sex were observed in mRCC systemic therapy utilization for Medicare beneficiaries from 2015-2019.
JNCI cancer spectrum. 2023 May 18 [Epub ahead of print]
Ryan D Chow, Jessica B Long, Sirad Hassan, Stephanie B Wheeler, Lisa P Spees, Michael S Leapman, Michael E Hurwitz, Hannah D McManus, Cary P Gross, Michaela A Dinan
Yale School of Medicine, New Haven, CT, U.S., Yale Cancer Outcomes, Public Policy, and Effectiveness Research Center, New Haven, CT, U.S., Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill (UNC-CH), Chapel Hill, NC, U.S., Department of Internal Medicine, Yale School of Medicine, New Haven, CT, U.S., Department of Medicine, Duke University School of Medicine, Durham, NC, U.S.