Kelson Tu'akoi, Janice Wong, Ha Nguyen, Chunhuan Lao, Mark Elwood, Mark McKeage, Ross Lawrenson
{"title":"在新西兰的Aotearoa对患有III期和IV期非小细胞肺癌的Māori进行全身抗癌治疗。","authors":"Kelson Tu'akoi, Janice Wong, Ha Nguyen, Chunhuan Lao, Mark Elwood, Mark McKeage, Ross Lawrenson","doi":"10.26635/6965.6917","DOIUrl":null,"url":null,"abstract":"<p><strong>Aims: </strong>We aimed to assess the frequency of systemic anti-cancer therapy (SACT) use in patients with advanced non-small cell lung cancer (NSCLC), comparing Māori and non-Māori. Secondary aims were to assess predictive factors for patients managed with SACT, SACT agent regimens and lung cancer-specific mortality.</p><p><strong>Methods: </strong>A retrospective cohort study of patients with incident advanced NSCLC in the Aotearoa New Zealand Midland Region between 1 January 2011 to 31 December 2021 was undertaken. Data were primarily derived from the Midland Lung Cancer Registry.</p><p><strong>Results: </strong>The study cohort comprised 2,549 patients with incident advanced NSCLC. A total of 775 patients were Māori (30%). SACT was received by 942 patients (37%). There was no difference in overall SACT rate between Māori and non-Māori: adjusted odds ratio (OR) 0.88 (95% confidence interval [CI] 0.71-1.09), p-value >0.05. For patients who received SACT, Māori were less likely to receive targeted therapy first-line (8.5% vs 16.1%, p-value <0.01). Māori had higher cancer-specific mortality: adjusted OR 1.19 (95% CI 1.08-1.32), p-value <0.001.</p><p><strong>Conclusion: </strong>In this pre-funded immunotherapy era, no difference was observed in overall SACT rate for Māori patients with advanced NSCLC. Māori were less likely to receive targeted therapy first-line, for which the underlying reasons require investigation. Our data suggest other factors, beyond overall SACT use rate, influence the higher cancer-specific mortality in Māori.</p>","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"138 1618","pages":"15-29"},"PeriodicalIF":1.2000,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Systemic anti-cancer treatment for Māori with stage III and IV non-small cell lung cancer in Aotearoa New Zealand.\",\"authors\":\"Kelson Tu'akoi, Janice Wong, Ha Nguyen, Chunhuan Lao, Mark Elwood, Mark McKeage, Ross Lawrenson\",\"doi\":\"10.26635/6965.6917\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aims: </strong>We aimed to assess the frequency of systemic anti-cancer therapy (SACT) use in patients with advanced non-small cell lung cancer (NSCLC), comparing Māori and non-Māori. Secondary aims were to assess predictive factors for patients managed with SACT, SACT agent regimens and lung cancer-specific mortality.</p><p><strong>Methods: </strong>A retrospective cohort study of patients with incident advanced NSCLC in the Aotearoa New Zealand Midland Region between 1 January 2011 to 31 December 2021 was undertaken. Data were primarily derived from the Midland Lung Cancer Registry.</p><p><strong>Results: </strong>The study cohort comprised 2,549 patients with incident advanced NSCLC. A total of 775 patients were Māori (30%). SACT was received by 942 patients (37%). There was no difference in overall SACT rate between Māori and non-Māori: adjusted odds ratio (OR) 0.88 (95% confidence interval [CI] 0.71-1.09), p-value >0.05. For patients who received SACT, Māori were less likely to receive targeted therapy first-line (8.5% vs 16.1%, p-value <0.01). Māori had higher cancer-specific mortality: adjusted OR 1.19 (95% CI 1.08-1.32), p-value <0.001.</p><p><strong>Conclusion: </strong>In this pre-funded immunotherapy era, no difference was observed in overall SACT rate for Māori patients with advanced NSCLC. Māori were less likely to receive targeted therapy first-line, for which the underlying reasons require investigation. Our data suggest other factors, beyond overall SACT use rate, influence the higher cancer-specific mortality in Māori.</p>\",\"PeriodicalId\":48086,\"journal\":{\"name\":\"NEW ZEALAND MEDICAL JOURNAL\",\"volume\":\"138 1618\",\"pages\":\"15-29\"},\"PeriodicalIF\":1.2000,\"publicationDate\":\"2025-07-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"NEW ZEALAND MEDICAL JOURNAL\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.26635/6965.6917\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"NEW ZEALAND MEDICAL JOURNAL","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.26635/6965.6917","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
摘要
目的:我们旨在评估晚期非小细胞肺癌(NSCLC)患者使用全身抗癌治疗(SACT)的频率,比较Māori和non-Māori。次要目的是评估SACT、SACT药物方案和肺癌特异性死亡率的预测因素。方法:对2011年1月1日至2021年12月31日期间新西兰中部地区发生的晚期非小细胞肺癌患者进行回顾性队列研究。数据主要来自米德兰肺癌登记处。结果:研究队列包括2549例晚期非小细胞肺癌患者。共775例患者Māori(30%)。942例(37%)患者接受SACT治疗。Māori和non-Māori的SACT总发生率无差异:校正优势比(OR) 0.88(95%可信区间[CI] 0.71-1.09), p值>0.05。对于接受SACT的患者,Māori接受一线靶向治疗的可能性较低(8.5% vs 16.1%, p值)。结论:在这个预先资助的免疫治疗时代,Māori晚期NSCLC患者的总体SACT率没有观察到差异。Māori不太可能接受一线靶向治疗,其潜在原因需要调查。我们的数据表明,除了SACT的总体使用率之外,其他因素也影响Māori较高的癌症特异性死亡率。
Systemic anti-cancer treatment for Māori with stage III and IV non-small cell lung cancer in Aotearoa New Zealand.
Aims: We aimed to assess the frequency of systemic anti-cancer therapy (SACT) use in patients with advanced non-small cell lung cancer (NSCLC), comparing Māori and non-Māori. Secondary aims were to assess predictive factors for patients managed with SACT, SACT agent regimens and lung cancer-specific mortality.
Methods: A retrospective cohort study of patients with incident advanced NSCLC in the Aotearoa New Zealand Midland Region between 1 January 2011 to 31 December 2021 was undertaken. Data were primarily derived from the Midland Lung Cancer Registry.
Results: The study cohort comprised 2,549 patients with incident advanced NSCLC. A total of 775 patients were Māori (30%). SACT was received by 942 patients (37%). There was no difference in overall SACT rate between Māori and non-Māori: adjusted odds ratio (OR) 0.88 (95% confidence interval [CI] 0.71-1.09), p-value >0.05. For patients who received SACT, Māori were less likely to receive targeted therapy first-line (8.5% vs 16.1%, p-value <0.01). Māori had higher cancer-specific mortality: adjusted OR 1.19 (95% CI 1.08-1.32), p-value <0.001.
Conclusion: In this pre-funded immunotherapy era, no difference was observed in overall SACT rate for Māori patients with advanced NSCLC. Māori were less likely to receive targeted therapy first-line, for which the underlying reasons require investigation. Our data suggest other factors, beyond overall SACT use rate, influence the higher cancer-specific mortality in Māori.