ABSTRACT Background There is little data on the relationship between socioeconomic factors and immunotherapy in advanced cutaneous squamous cell carcinoma of the head and neck (cSCCHN). Methods Our study analyzed patients with Stage IV cSCCHN diagnosed between 2018–2026 using the EPIC Cosmos database. Socioeconomic status was measured based on the social vulnerability index (SVI) and corresponding themes. Immunotherapy receipt was evaluated with Robust Poisson models. Results A total of 1140 patients were identified with Stage IV cSCCHN, with 338 (29.6%) of whom received immunotherapy. Higher SVI was associated with a lower likelihood of receiving immunotherapy (incidence rate ratio = 0.96). Patients in the most vulnerable overall SVI quintile had a 29% lower rate of receiving immunotherapy compared to the least vulnerable quintile ( p = 0.018). Participants' race/ethnicity, insurance status, and urbanicity were not significantly associated with immunotherapy receipt. Conclusion Increased social vulnerability is associated with reduced likelihood of treatment with immunotherapy among patients with Stage IV cSCCHN.
Hung et al. (Sun,) studied this question.
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