Abstract 528P
Background
Precision medicine has been increasingly practiced to select best-fit systemic treatment for advanced and metastatic (a/m) NSCLC. Though new treatment options help improve survival outcomes, they have led to increased financial burdens. In Hong Kong, limited financial assistance programs place the majority of treatment cost on patients. Our study aims to identify gaps in accessing standard-of-care (SOC) treatments and its determinants.
Methods
This prospective, territory-wide cohort study enrolled newly diagnosed a/m NSCLC patients from seven public oncology centers in Hong Kong since Mar 2021. Data on genomic landscape, treatment patterns and socioeconomic status (SES) of NSCLC patients were collected. Provision of SES data was voluntary. Patients were dichotomized into with or without druggable mutations. Proportion of patients receiving SOC were reported and analyzed in relation with SES parameters.
Results
Among 350 patients with SES data, 194 (55.5%) paid out-of-pocket costs for treatments, 110 (31.5%) were partially reimbursed by means-tested subsidy and 34 (9.7%) were fully reimbursed in employee remuneration package. Household income (HI) of 215 patients (60.9%) is less than 23000 USD/year, 95 (26.9%) between 23001-55300 USD/year, and 43 (12.1%) above 55301 USD/year. About 50% of patients had at least 2 children, lived with family members and received secondary education or above. For patients with druggable mutation (n=259), 152 (58.7%) received corresponding targeted treatments. In multivariate analyses (MVA), patients with HI >= 23001 USD/yr is significantly more likely to follow SOC than those with lower income. Self-financed patients are significantly more likely to receive targeted therapies than those with subsidy (OR: 3.73, p=0.004). For patients without druggable mutation (n=77), 32 (52%) received immunotherapy alone or combination. In MVA, patients with HI above 55301 USD/year are more likely to receive immunotherapy as part of treatment than those with lower income (OR: 11.90, p=0.08).
Conclusions
Patients with HI below 55301 USD/year is at risk of deprivation to accessing SOC treatment. Societal efforts are needed to secure equitable access to cancer treatment to all.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The University of Hong Kong.
Funding
Innovation and Technology Commission (HKSAR) & Roche.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
73TiP - Global phase III studies evaluating vepdegestrant in estrogen receptor (ER)+/human epidermal growth factor receptor 2 (HER2)- advanced breast cancer: VERITAC-2 and VERITAC-3
Presenter: Hiroji Iwata
Session: Poster Display
Resources:
Abstract
78P - First-in-human phase I study of TT-00434, an orally available FGFR (1-3) inhibitor in patients with advanced solid tumors
Presenter: Chia Jui Yen
Session: Poster Display
Resources:
Abstract
79P - Accelerated identification of recurrent neoantigens for the development of off-the-shelf cancer vaccines
Presenter: Le Son Tran
Session: Poster Display
Resources:
Abstract
80P - Safety, preliminary efficacy, and pharmacokinetics of HLX26 plus serplulimab in advanced solid tumours: An open-label, dose-escalation phase I study
Presenter: Yanmin Wu
Session: Poster Display
Resources:
Abstract
81P - A first-in-human, multiple dose and dose escalation phase I study to investigate the safety, tolerability and antitumor activity of SmarT cells plus PD-1 blocking antibodies in patients with far advanced/metastatic solid tumors
Presenter: Qin Liu
Session: Poster Display
Resources:
Abstract
82P - NEXUS: A phase I dose escalation study of selinexor plus nivolumab and ipilimumab in Asian patients with advanced/metastatic solid malignancies
Presenter: Gloria Chan
Session: Poster Display
Resources:
Abstract
83P - The updated report of phase I trial of VG2025, a non-attenuated HSV-1 oncolytic virus expressing IL-12 and IL-15/RA payloads, in patients with advanced solid tumors
Presenter: Yinan Shen
Session: Poster Display
Resources:
Abstract
84P - T cell receptor repertoire profiles of tumor -infiltrating lymphocytes improves neoantigen prioritization for personalized cancer immunotherapy
Presenter: Tran Nguyen
Session: Poster Display
Resources:
Abstract
85P - Oligometastatic solid tumors: Disease characteristics and role of local therapies
Presenter: Alshimaa Al Hanafy
Session: Poster Display
Resources:
Abstract
86P - Efficacy and safety of HLX07 monotherapy in advanced cutaneous squamous cell carcinoma: An open-label, multicentre phase II study
Presenter: Changxing Li
Session: Poster Display
Resources:
Abstract