|The following article features coverage from the American Society of Clinical Oncology 2020 meeting. Click here to read more of Cancer Therapy Advisor‘s conference coverage.|
Results of a retrospective analysis released during the ASCO20 Virtual Scientific Program suggested that prescribing cancer medications in accordance with National Comprehensive Cancer Network (NCCN) guidelines appeared to confer better disease-specific survival for patients across 8 different malignancies found in the California Cancer Registry during 2004 to 2016.
Conversely, prescribing in a manner that was discordant with NCCN’s recommendations was linked to increased disease-specific mortality across the following malignancies: breast cancer (189,311 cases; hazard ratio [HR], 1.28; 95% CI, 1.23-1.33), prostate cancer (156,502 cases; HR, 1.31; 95% CI, 1.22-1.41), colon cancer (80,102 cases; HR, 1.73; 95% CI, 1.67-1.78), liver cancer (25,857 cases; HR, 2.52; 95% CI, 2.42-2.63), rectal cancer (30,118 cases; not applicable), gastric (22,066 cases; HR, 2.38; 95% CI, 2.28-2.49), ovarian cancer (22,511 cases, HR, 1.32; 95% CI, 1.26-1.38), and cervical cancer (16,691 cases; HR, 1.17; 95% CI, 1.08-1.26).
The investigators used multivariate logistic regression to determine how a patient’s race/ethnicity, socioeconomic status (SES), insurance type, and tumor type may have influenced the type of care they received. The team also examined survival in relation to adherence to the NCCN guidelines.
Whether a patient received NCCN guideline-concordant care seemed to depend most heavily on race and insurance status. Black patients and those on Medicaid were less likely to receive guideline-concordant medications compared with white patients and those who had managed care insurance plans. Patients of lower socioeconomic status were also less likely to receive NCCN-adherent care across all cancer types except cervical cancer (P <.0001).
Specifically, non-Hispanic black patients were less likely to receive drugs suggested by the NCCN in breast cancer (odds ratio [OR], 0.88; 95% CI, 0.84-0.92), prostate cancer (OR, 0.90; 95% CI, 0.86-0.93), colon cancer (OR, 0.85; 95% CI, 0.79-0.92), and ovarian cancer (OR, 0.71; 95% CI, 0.62-0.82).
Hispanic patients were less likely to receive NCCN-concordant care in breast, prostate, and liver cancers; Asian patients were less likely to receive guideline-adherent treatment in breast and liver cancers.
Having Medicaid also decreased a patient’s likelihood of receiving a therapy endorsed by the NCCN; this effect was seen in breast, prostate, colon, rectal, gastric, and liver cancers (P <.0001).
In all, less than half of patients (47.5%) with cancer that were included in the analysis received anticancer therapies that were consistent with those highlighted in NCCN guidelines. Patients who received care outside of these recommendations had worse disease-specific survival.
Read more of Cancer Therapy Advisor‘s coverage of the ASCO 2020 meeting by visiting the conference page.
Clair K, Chang J, Ziogas A, et al. Disparities by race, socioeconomic status, and insurance type in the receipt of NCCN guideline concordant care for select cancer types in California. Presented at: ASCO20 Virtual Scientific Program. J Clin Oncol. 2020;38(suppl):abstr 7031.