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You have accessJournal of UrologyDiversity, Equity & Inclusion: Health Equity & Outcomes I (PD05)1 May 2024PD05-11 SOCIOECONOMIC AND DEMOGRAPHIC DISPARITIES IN IMMUNOTHERAPY FOR ADVANCED RENAL CELL CARCINOMA AND UROTHELIAL CARCINOMA Levi Holland, Nathanaelle Ibeziako, Raj Bhanvadia, Jacob Taylor, Deitrich Gerlt, Iftach Chaplin, Aditya Bagrodia, Tian Zhang, Suzanne Cole, Kris Gaston, Yair Lotan, Vitaly Margulis, and Solomon Woldu Levi HollandLevi Holland , Nathanaelle IbeziakoNathanaelle Ibeziako , Raj BhanvadiaRaj Bhanvadia , Jacob TaylorJacob Taylor , Deitrich GerltDeitrich Gerlt , Iftach ChaplinIftach Chaplin , Aditya BagrodiaAditya Bagrodia , Tian ZhangTian Zhang , Suzanne ColeSuzanne Cole , Kris GastonKris Gaston , Yair LotanYair Lotan , Vitaly MargulisVitaly Margulis , and Solomon WolduSolomon Woldu View All Author Informationhttps://doi.org/10.1097/01.JU.0001008624.07191.ab.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Immunotherapy (IO) drugs have been increasingly utilized in locally advanced or metastatic clear cell renal cell carcinoma (ccRCC) and urothelial carcinoma of the bladder (UC). Multiple trials have demonstrated clear survival benefit, however, there are often barriers to access these advanced therapies which has been demonstrated in other malignancies such as melanoma and lung cancer. The goal of our study was to assess socioeconomic and demographic factors associated with the receipt of IO for advanced ccRCC and UC. METHODS: We queried the National Cancer Database (NCDB) for patients with stage IV ccRCC and UC. The study period was 2015-2020 for ccRCC (FDA approval date of IO) and 2017-2020 for UC (FDA approval date of broadened indication for IO, initial limited approval was in 2016). Major exclusion criteria were unknown receipt of IO, unknown staging, and non-clear cell or non-urothelial predominant histology for ccRCC and UC, respectively. The primary outcome of interest was receipt of IO therapy using multivariable logistic regression, adjusting for relevant socioeconomic and demographic variables. RESULTS: We identified 15926 patients with stage IV ccRCC and 10380 patients with stage IV UC of which 5419 (34.0%) and 2231 (21.5%) received IO therapy, respectively. Multivariable analysis presented in Tables 1 and 2. Statistically significant differences were identified in both malignancies related to age, education, income, insurance status, and facility type. For ccRCC, black race and Hispanic ethnicity was also significant. CONCLUSIONS: In the era of FDA approved IO therapy, this national cohort analysis suggests that IO utilization is increasing over time, but significant disparities exist based on income, education, and insurance status in both malignancies. For ccRCC, additional disparities were seen in those of black race and Hispanic ethnicity. Additionally, non-academic facilities were less likely to administer IO therapy. Further study to identify and address etiologies of these disparities are imperative. Source of Funding: none © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e94 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Levi Holland More articles by this author Nathanaelle Ibeziako More articles by this author Raj Bhanvadia More articles by this author Jacob Taylor More articles by this author Deitrich Gerlt More articles by this author Iftach Chaplin More articles by this author Aditya Bagrodia More articles by this author Tian Zhang More articles by this author Suzanne Cole More articles by this author Kris Gaston More articles by this author Yair Lotan More articles by this author Vitaly Margulis More articles by this author Solomon Woldu More articles by this author Expand All Advertisement PDF downloadLoading ...
Holland et al. (Mon,) studied this question.