Black Patients Have Similar Immune Checkpoint Inhibitor Effectiveness, Lower Toxicity
THURSDAY, Dec. 5, 2024 -- Black patients have similar immune checkpoint inhibitor (ICI) effectiveness and lower toxicities compared with White patients, according to a study published online Nov. 14 in The Lancet Oncology.
Sean Miller, M.D., from the Veterans Affairs Ann Arbor Healthcare System in Michigan, and colleagues conducted a retrospective cohort study to characterize the effectiveness and safety of ICIs in Black patients. All patients in the U.S. Veterans Health Administration system Corporate Data Warehouse who self-identified as non-Hispanic Black or African American or non-Hispanic White and received PD-1, PD-L1, CTLA-4, or LAG-3 inhibitors between Jan. 1, 2010, and Dec. 31, 2023, were included.
Data were included for 26,398 patients: 18.7 percent Black and 81.3 percent White. The researchers found that Black patients had longer time to treatment discontinuation compared with White patients (two-year unadjusted rates, 10.7 versus 8.6 percent; adjusted hazard ratio, 0.91); similar time to next treatment (23.5 versus 25.6 percent for White patients); and slightly improved overall survival (36.5 versus 36.5 percent for Black versus White patients; hazard ratio, 0.95). Black patients had a reduced risk for all-grade immune-related adverse events compared with White patients; immune-related adverse events requiring treatment with systemic steroids; and immune-related adverse events resulting in permanent ICI discontinuation (adjusted hazard ratios, 0.75, 0.61, and 0.58, respectively).
"To our knowledge, this study is the largest analysis of ICI efficacy and safety in Black patients to date, a population severely under-represented in ICI clinical trials, and raises crucial questions regarding the reasons for lower observed immune-related adverse events than in White patients," the authors write.
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