Supplementary Materials1

Supplementary Materials1. age-based gap showed a decrease over time (OR=0.93). For untested patients, erlotinib treatment was associated with race (OR=0.58, black vs. white; OR=2.45, Asian vs. white), and was more likely among female patients (OR=1.45); for tested patients, erlotinib treatment was less likely among low-income patients (OR=0.32). Most of these associations persisted or increased in magnitude. Conclusions: Race and sex are associated with rates of erlotinib treatment for patients who did not receive genetic testing, and low-income status is associated with treatment rates for those who did receive testing. The racial disparity remained stable over time, while the income-based disparity grew larger. Impact: Attention to reducing disparities is needed as precision cancer treatments continue to be developed. INTRODUCTION Lung cancer, the most common cause of cancer death in america, can be projected to take into account 25% of tumor mortality BAPTA tetrapotassium in 2018 [1]. Less than 10% of these with stage 4 tumor survive much longer than five years [2], and nearly all individuals with non-small cell lung tumor (NSCLC), the most frequent lung tumor subtype, possess stage 4 disease at period of analysis [3]. Because the past due 1990s, the introduction of targeted tumor therapy has appreciably altered the landscape of lung cancer treatment by becoming a routine element of care for late-stage NSCLC [4]. Targeted therapy drugs inhibit specific molecular pathways associated with cancer growth, e.g., the pathway driven by the epidermal growth factor receptor (EGFR) tyrosine kinase. Approximately 3 in 10 NSCLC patients possess an EGFR mutation, with prevalence varying based on patient factors such as ethnicity [5, 6], and patients with certain types of EGFR mutation (i.e., exon 19 deletion or L858R mutation in exon 21) have better outcomes when treated with an EGFR tyrosine kinase inhibitor (TKI) than with standard chemotherapy BAPTA tetrapotassium [7]. Reports from as early as 2004 first indicated that EGFR mutations were associated with responsiveness to EGFR TKIs [8]. NCCN guidelines encouraged genetic testing in 2007, but it was not definitively recommended due to lack of consensus until 2011 [9, 10], at which point it was recommended for all advanced NSCLC patients BAPTA tetrapotassium considered for first-line EGFR targeted therapy regardless of patient characteristics such as age and sex [10]. EGFR TKIs are currently only one of several precision treatment options available for NSCLC. In recent years, lung cancer immunotherapies, including programmed death-1/programmed death ligand-1 (PD-1/PD-L1) inhibitors, have also shown promising results [11]. Biomarker testing more generally C including genetic testing for EGFR mutations and testing for elevated PD-L1 expression levels C is currently recommended for NSCLC patients to determine eligibility for lung cancer precision treatments [12, 13]. While precision treatments have yielded promising advancements in NSCLC treatment, utilization of some of these therapies is disproportionate Rabbit Polyclonal to EGFR (phospho-Tyr1172) across strata defined by race and socioeconomic status (SES). A reduced BAPTA tetrapotassium likelihood of receiving EGFR mutation testing is associated with factors suggesting lower socioeconomic status, including status as a Medicaid beneficiary [8] and patient residence in a relatively low-income area. The latter is also associated with lower rates of treatment with erlotinib, an EGFR TKI [14]. Hospitals located in areas with more high-income or more highly-educated residents are more likely to order EGFR testing for patients [9]. A recent study also showed that blacks and Hispanics were less likely and Asians more likely than whites to receive EGFR testing[8]. Racial disparities in cancer treatment have already been well-documented [15-18]; regarding targeted therapy remedies in particular, it’s been found that dark individuals are not as likely than white individuals to receive human being epidermal development elements 2 (HER2)-targeted treatments for breast cancers [19], and dark renal tumor individuals show BAPTA tetrapotassium worse success than whites actually after the development of targeted therapy predicated on vascular endothelial development element (VEGF) inhibition [20, 21]. Despite these scholarly research on disparities in tumor treatment, little is well known about whether such discrepancies are steady, developing, or shrinking as time passes within the framework from the rapidly-evolving and.