Non-small cell lung cancer chemotherapy treatment outcomes and ethnicity: a twenty-year single-centre patterns of care study.

Abstract

To investigate the treatment of patients with advanced-stage non-small cell lung cancer (NSCLC) over a 20-year period in a single Aotearoa New Zealand centre with reference to the use of systemic anti-cancer chemotherapy (SACT) and to explore ethnic disparities in treatment and outcomes. Using a SACT database maintained by the Oncology Department at Waikato Hospital, Hamilton, Aotearoa New Zealand from 2000 to 2021 we derived summary statistics for patient factors and SACT regimens by ethnicity (Māori and non-Māori). We investigated Kaplan-Meier all-cause survival by ethnicity and SACT. Logistic regression was used to estimate the odds ratios of surviving 12 months and receiving first and second SACT. One thousand and fifty-seven patients with advanced NSCLC were included, with 30% identified as Māori and 53% treated with SACT. The median survival for non-Māori and Māori receiving SACT was 11.9 and 8.5 months respectively (unadjusted odds ratio of surviving 12 months: 1.968; 95% CI: 1.352-2.865; p<0.001). Non-Māori receiving SACT were 86.2% more likely to survive 12 months than Māori. There were no ethnic disparities in the proportion of patients receiving first-line SACT; however, non-Māori were 1.5 times more likely to receive a second SACT than Māori. Significant ethnic difference between Māori and non-Māori exists for both survival and receipt of second-line SACT.