Treatment adherence and clinical outcomes of osimertinib in minority patients with advanced EGFR mutated NSCLC

Cancer research · NSCLC · EGFR · osimertinib

NHB patients had significantly worse overall survival compared with NHW patients when treated with osimertinib for advanced EGFR‑mutated NSCLC.

Osimertinib has been one of the most commonly prescribed first‑line treatments for EGFR‑mutated advanced NSCLC for the last several years for patients with EGFR‑mutated non‑small cell lung cancer (NSCLC), yet clinical outcomes among racial and ethnic minority patients remain poorly characterized due to underrepresentation in pivotal trials. We conducted a retrospective study of 174 patients with advanced EGFR‑mutated NSCLC treated at the Montefiore Einstein Comprehensive Cancer Center (MECCC) from 2015 to 2024 to evaluate real‑world survival and treatment adherence. The cohort included 32.2% Hispanic, 28.7% non‑Hispanic Black (NHB), 26.4% non‑Hispanic White (NHW), and 12.6% Asian patients. In multivariable analyses, NHB patients experienced significantly worse overall survival compared with NHW patients, both in the overall cohort (Hazard ratio (HR) 1.83, 95% confidence interval (CI) 1.02–3.27) and in first‑line osimertinib users (HR 3.42, 95% CI 1.48–7.88), despite similar adherence rates. Hispanic and Asian patients also showed trends toward inferior outcomes. These findings highlight survival disparities and underscore the need for inclusive trials and targeted strategies.

The study demonstrates that racial disparities persist in real‑world outcomes for osimertinib treatment, emphasizing the imperative to design and enroll diverse patient populations in clinical research and to explore tailored therapeutic strategies to mitigate inequities in lung cancer care.

Evidence level: Klinikai vizsgálat. Formális klinikai vizsgálati eredmény.

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