Impact of race and gender on outcomes from patients with stage IV non-small cell lung cancer receiving immunotherapy: A retrospective study performed at Mitchell Cancer Institute, Mobile, AL.

e20562 Background: The use of immunotherapy is associated with improved survival among patients with Non-Small Cell Lung Cancer (NSCLC). The impact of race and gender on survival with immunotherapy is limited and conflicting. Our study sought to examine the influence of race and gender on the outcomes of patients with stage IV NSCLC treated with first line immunotherapy. Methods: A retrospective review of 91 patients with stage IV NSCLC was performed. Patients with confirmed NSCLC who received first line immunotherapy between January 2018 to December 2022 identified from Mitchell Cancer Institute (MCI) Cancer Registry were analyzed for clinical outcomes. Disease-specific survival was evaluated and compared among patients across racial/ethnic categories using mean, standard deviation, median, and interquartile range. Mean outcomes for numerical factors were compared using a t-test, while median outcomes were compared using a median test. The association between categorical factors was assessed using Fisher’s test, with a significance level of 0.05. Results: A total of 91 patients (45 [49.5%] male) were included in the analysis, with 61 White (67.0%; mean [SD] age, 70.2 [10.1] years) and 30 African American [AA] (32.9%; mean [SD] age, 65.9 [9.2] years). Based on histological analysis 71(77.8%) were adenocarcinoma, 18 (19.8%) squamous cell carcinoma, and 2 (2.2%) adenosquamous carcinoma. Mean progression free survival (PFS) was greater in Whites (315 vs 178 days; p = 0.041). Mean overall survival (OS) was longest in Whites (397 vs 218 days; p = 0.016). No significant differences were observed in age at diagnosis (p = 0.096), mean cycles given (p = 0.406) and PD-L1 status (p = 0.077) between Whites and AA’s. No significant differences were observed in age at diagnosis (p = 0.184), mean cycles given (p = 0.729) and time to progression (p = 0.769) or death (p = 0.938) between genders. PD-L1 distribution differed between males and females (p = 0.021) with a higher percentage of females having PD-L1 ≥1% (63% vs 38%). Conclusions: Our study showed longer PFS and OS in White patients receiving first line immunotherapy in stage IV NSCLC regardless of age at diagnosis or PD-L1 status. No differences in PFS or OS were seen between genders irrespective of age at diagnosis, mean cycles of treatment or PD-L1 status. These findings demonstrate the importance of integrating race, ethnicity, and gender as prognostic variables in the evaluation of patients with NSCLC in the incorporation of social determinants of health. This inclusion is crucial to obtain a more comprehensive understanding of how these factors influence patient outcomes.