WCLC 2025 - Posters & ePosters-P3.13.07 Real-World Implementation of Immunotherapy for Stage III-IV Small Cell Lung Cancer: Insights From the National Cancer Database (2016-2021)

P3.13.07 Real-World Implementation of Immunotherapy for Stage III-IV Small Cell Lung Cancer: Insights From the National Cancer Database (2016-2021)

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This retrospective study analyzed National Cancer Database data from 2016 to 2021, encompassing 55,000 patients diagnosed with extensive-stage (Stage III-IV) small cell lung cancer (ES-SCLC) in the United States, to assess real-world trends and disparities in the use of immune checkpoint inhibitors (ICIs). The primary outcome was receipt of immunotherapy, with trends tracked annually and factors influencing ICI use evaluated via multivariable logistic regression, focusing on socioeconomic, demographic, and facility-related variables.<br /><br />Key findings revealed a marked increase in ICI adoption following pivotal clinical trials: utilization rose from 1.7% in 2016 to 42% in 2021, with a significant uptake beginning in 2018. Despite this growth, fewer than half of patients received immunotherapy in 2021, highlighting a gap between guideline recommendations and clinical practice.<br /><br />Analysis of disparities showed variations in ICI receipt associated with race/ethnicity, insurance status, income, education level, and treatment facility type. For example, patients with private insurance were more likely to receive ICIs than those with Medicaid, and academic centers demonstrated higher utilization compared to non-academic facilities. These socioeconomic and demographic factors indicate inequitable access to immunotherapy treatments among ES-SCLC patients.<br /><br />The authors conclude that although immunotherapy use has substantially increased in recent years, significant barriers remain that prevent broad, equitable implementation. They emphasize the urgent need for strategies to close access gaps and ensure that advances in immunotherapy are delivered fairly across diverse populations. Continued research should focus on understanding and addressing these disparities to improve treatment outcomes for all patients with advanced small cell lung cancer.

Asset Subtitle

Brittany Morguelan

Meta Tag

Speaker Brittany Morguelan

Topic Small Cell Lung Cancer and Neuroendocrine Tumors

Keywords

extensive-stage small cell lung cancer

immune checkpoint inhibitors

immunotherapy trends

National Cancer Database

healthcare disparities

socioeconomic factors

insurance status

treatment facility type

real-world data

multivariable logistic regression