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Socioeconomic Disparities Impact Immunotherapy Use in Urologic Cancers

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Disparities seen based on income, education, and insurance status for both advanced kidney, bladder cancer

By Lori Solomon HealthDay Reporter

FRIDAY, Sept. 6, 2024 (HealthDay News) — Immunotherapy (IO) utilization is increasing over time, but significant socioeconomic disparities exist for patients with advanced clear cell renal cell carcinoma (ccRCC) and urothelial carcinoma of the bladder (UC), according to a study published in the November issue of Urologic Oncology: Seminars and Original Investigations.

Levi Holland, M.D., from the University of Texas Southwestern Medical Center in Dallas, and colleagues assessed socioeconomic and demographic factors associated with the receipt of IO for advanced ccRCC and UC. The analysis included patients with stage IV ccRCC (15,926 individuals) or UC (10,380 individuals) identified from the National Cancer Database.

The researchers found that 34.0 percent of patients with ccRCC and 21.5 percent with UC received IO therapy, with IO utilization increasing in each successive year. Treatment at a nonacademic facility, education level, income, and insurance were independently associated with IO utilization for both malignancies. For ccRCC, decreased IO use was seen for Black race (odds ratio, 0.77) and Hispanic race (odds ratio, 0.73). For UC, there were no independent associations noted between race and receipt of IO.

“With the rapidly changing pace of innovation in cancer therapeutics, it is important that all patients have access to novel, potentially lifesaving medications,” lead author Solomon Woldu, M.D., also from UT Southwestern, said in a statement. “Our study highlights critical gaps in health care equity when it comes to treatments that have been shown effective in prolonging survival.”

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