WCLC 2025 - Posters & ePosters-P3.12.16 Reduced Survival in Black Patients With EGFR-Mutant NSCLC

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This retrospective study reviewed electronic medical records of 337 patients with EGFR-mutant non-small cell lung cancer (NSCLC) treated between 2019 and 2024 at Cedars-Sinai Medical Center (Los Angeles) and Henry Ford Hospital (Detroit). Inclusion criteria were confirmed EGFR mutations and first-line treatment with osimertinib monotherapy for metastatic disease. The cohort included 62 Black or African American (AA), 71 Asian, and 204 White patients. Patient characteristics were statistically compared by race, and survival outcomes—progression-free survival (PFS) at 18 months and overall survival (OS)—were analyzed using multivariable logistic regression and Kaplan-Meier methods.<br /><br />Significant racial differences emerged: Black patients demonstrated notably poorer outcomes. Median OS was 31.5 months for Black patients, significantly lower than 68.4 months for Asians and 59.5 months for Whites (p=0.013). Multivariable regression revealed that, compared to Black patients, Asian and White patients had substantially higher odds of achieving PFS beyond 18 months (OR 16.64 and 14.47, respectively; p=0.001 for both). Although age and smoking status varied across groups, these factors did not explain the survival differences. Black patients were slightly younger at diagnosis and had a lower proportion of never smokers compared to Asians and Whites.<br /><br />This study represents the largest cohort of Black patients with EGFR-mutant NSCLC treated with osimertinib from two urban centers, addressing a critical gap in representation. The findings highlight persistent racial disparities in treatment response and survival despite standard targeted therapy. These disparities likely reflect multifactorial causes beyond access and smoking history, such as biological variation or other social determinants. The authors conclude that understanding and addressing these racial differences is essential to ensuring equitable, high-quality care for all patients with EGFR-mutant NSCLC. This work emphasizes the urgent need for inclusion of diverse populations in research and tailored interventions to improve outcomes in underserved groups.

Asset Subtitle

Karen Reckamp

Meta Tag

Speaker Karen Reckamp

Topic Metastatic Non-small Cell Lung Cancer – Targeted Therapy

Keywords

EGFR-mutant non-small cell lung cancer

osimertinib monotherapy