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Differences in Receipt of Immunotherapy Treatment Among Patients With Head and Neck Cancer.

Publication ,  Journal Article
Ramkumar, SP; Bhardwaj, A; Patel, A; Seetharaman, K; Christman, A; Amondikar, N; Abouelella, DK; Hussaini, AS; Barnes, JM; Adjei Boakye, E ...
Published in: JAMA Otolaryngol Head Neck Surg
October 1, 2023

IMPORTANCE: The US Food and Drug Administration approved immune checkpoint inhibitors (immunotherapy) for select cases of head and neck squamous cell carcinoma (HNSCC) in 2016. However, it is unclear whether there are clinical or sociodemographic differences among patients receiving immunotherapy as part of their care. Given the known disparities in head and neck cancer care, we hypothesized that there are differences in receipt of immunotherapy among patients with HNSCC based on clinical and nonclinical characteristics. OBJECTIVE: To characterize clinical and nonclinical factors associated with receipt of immunotherapy among older patients with HNSCC. DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study included patients 65 years or older diagnosed with HNSCC (n = 4860) in a community oncology care setting. Electronic health records from Navigating Cancer were assessed from January 1, 2017, to April 30, 2022. MAIN OUTCOMES AND MEASURES: Multivariable logistic regression was used to characterize clinical (tumor stage [localized vs advanced] and anatomical subsite [oropharyngeal vs nonoropharyngeal]) and nonclinical (age, smoking history, race and ethnicity, sex, and marital status) factors associated with receipt of immunotherapy. RESULTS: In the study cohort of 4860 patients, 3593 (73.9%) were men; 4230 (87.0%) were White and 630 (13.0%) were of other races. A total of 552 patients (11.4%) had received immunotherapy. After adjusting for covariates, in the final model, White patients with HNSCC had 80% increased odds of receiving immunotherapy (adjusted odds ratio [AOR], 1.80 [95% CI, 1.30-2.48]) compared with patients of other races. There were no statistically significant differences in the odds of receiving immunotherapy based on age, sex, or smoking history. Patients with nonoropharyngeal disease were significantly more likely to receive immunotherapy than those with oropharyngeal cancer (AOR, 1.29 [95% CI, 1.05-1.59]), as were those with advanced compared with local disease (AOR, 2.39 [95% CI, 1.71-3.34]). CONCLUSIONS AND RELEVANCE: The findings of this cohort study suggest that among older patients with HNSCC, White patients may be more likely to receive immunotherapy as part of their care. Equitable access to immunotherapy and other treatment options will reduce cancer-related health disparities and improve survival of patients with HNSCC.

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Published In

JAMA Otolaryngol Head Neck Surg

DOI

EISSN

2168-619X

Publication Date

October 1, 2023

Volume

149

Issue

10

Start / End Page

912 / 918

Location

United States

Related Subject Headings

  • 4201 Allied health and rehabilitation science
  • 3203 Dentistry
  • 3202 Clinical sciences
 

Citation

APA
Chicago
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Ramkumar, S. P., Bhardwaj, A., Patel, A., Seetharaman, K., Christman, A., Amondikar, N., … Osazuwa-Peters, N. (2023). Differences in Receipt of Immunotherapy Treatment Among Patients With Head and Neck Cancer. JAMA Otolaryngol Head Neck Surg, 149(10), 912–918. https://doi.org/10.1001/jamaoto.2023.2420
Ramkumar, Shreya P., Arun Bhardwaj, Amila Patel, Krishnamoorthy Seetharaman, Amanda Christman, Ninad Amondikar, Dina K. Abouelella, et al. “Differences in Receipt of Immunotherapy Treatment Among Patients With Head and Neck Cancer.JAMA Otolaryngol Head Neck Surg 149, no. 10 (October 1, 2023): 912–18. https://doi.org/10.1001/jamaoto.2023.2420.
Ramkumar SP, Bhardwaj A, Patel A, Seetharaman K, Christman A, Amondikar N, et al. Differences in Receipt of Immunotherapy Treatment Among Patients With Head and Neck Cancer. JAMA Otolaryngol Head Neck Surg. 2023 Oct 1;149(10):912–8.
Ramkumar, Shreya P., et al. “Differences in Receipt of Immunotherapy Treatment Among Patients With Head and Neck Cancer.JAMA Otolaryngol Head Neck Surg, vol. 149, no. 10, Oct. 2023, pp. 912–18. Pubmed, doi:10.1001/jamaoto.2023.2420.
Ramkumar SP, Bhardwaj A, Patel A, Seetharaman K, Christman A, Amondikar N, Abouelella DK, Hussaini AS, Barnes JM, Adjei Boakye E, Watts TL, Osazuwa-Peters N. Differences in Receipt of Immunotherapy Treatment Among Patients With Head and Neck Cancer. JAMA Otolaryngol Head Neck Surg. 2023 Oct 1;149(10):912–918.

Published In

JAMA Otolaryngol Head Neck Surg

DOI

EISSN

2168-619X

Publication Date

October 1, 2023

Volume

149

Issue

10

Start / End Page

912 / 918

Location

United States

Related Subject Headings

  • 4201 Allied health and rehabilitation science
  • 3203 Dentistry
  • 3202 Clinical sciences