Racial Disparities in Survival Among Advanced Non-Small Cell Lung Cancer Patients First-Treated with The Combination of Paclitaxel and Platinum

Abstract

Background: In clinical practice, different chemotherapy schedules for NSCLC have potential impacts on overall survival, but not specific in NCCN guidelines. Although some meta-analyses have been conducted to identify the influencing factors, the results are limited by method. Our study is helpful to supplement the NCCN Guidelines.Methods: In order to evaluate and quantify the potential relationship between demographic characteristics, disease characteristics, etc. and overall survival as well as their impact on objective response rate and safety, we developed parametric proportional hazard regression models to describe the overall survival of advanced NSCLC patients first-treated with the paclitaxel-platinum regimen. Results: The principal finding of this research was that race significantly affected hazard of dying. Hazard of dying was 1.4 times higher in non-East Asians than in East Asians, and the hazard ratio of the OS curve was 0.71(95%CI: 0.65-0.78). The median survival time in East Asians and non-East Asians were estimated as 12.2 (95%CI: 10.5, 14.4) and 8.4 (95%CI: 6.5. 11.0) months, respectively. The ORR was 37% (95%CI: 32, 41) and 28% (95%CI: 25, 32) in East Asians and non-East Asians, respectively. Conclusions: Paclitaxel-platinum regimen had different efficacy in two racial groups. The developed model suggests that the efficacy and safety of paclitaxel-platinum regimen can vary between different racial populations because of differences in influencing factors (doses, platinum type, cycles, etc.)