Real-world analysis of the impact of race on immunotherapy in non-small cell lung cancers.

e18692 Background: Immunotherapy (IO) has become an essential component in the treatment of NSCLC. However, there is limited data on the clinical impact of IO in distinct ethnic minorities who have been greatly under-represented in previous IO trials. It remains unclear whether Black patients carry similar characteristics and responses compared to Non-Black patients. Methods: Patients who were diagnosed with NSCLC from 1/1/2013 to 12/31/18 and confirmed to have received IO were identified from the Montefiore cancer network. Black and Non-Black patients’ characteristics were compared in patient clinical and socioeconomic variables by chi-squared, Mann-Whitney tests and two sample t-tests. Overall survival (OS) and progression free survival (PFS) were evaluated by Kaplan-Meier survival analysis and log-rank analysis using R 4.1.2 version. Results: Of the 108 patients that were analyzable, overall median age was 67 (range 45-86) years old, 35% were Black, 80% smokers/former smokers, 73% were metastatic, 53% treated with PD-l/PD-L1 inhibitor-based IO alone and 65% on first-line immunotherapy regimens. PD-L1 testing were performed in 88 (81%) of patients, including 33 (87%) Black and 55 (79%) Non-Blacks. PD-L1 TPS≥1% was found in 26 (68%) of Blacks and 42 (60%) of Non-Blacks but no significant difference between the two groups (p = 0.792). Overall, median follow-up time was 19.7 months, 50% of patients had disease control with either a complete/partial response or stable disease within 3 months of starting IO but again was not significantly different between Black and Non-Black patients (p = 0.591). Furthermore, there was no significant difference in PFS (8.2 vs. 6.2 months, p = 0.210) and OS (10.9 vs. 9.8 months, p = 0.438). Nevertheless, there was a significantly longer duration of IO in the Blacks (median 7.4 months) compared to the Non-Blacks (3.9 months) (p = 7.17E-07) (Table). Conclusions: Although the response and survival outcomes of IO were not significantly different between Black and Non-Black patients, the duration of IO is significantly longer in Black patients. This finding warrants further exploration on the reasoning behind this which may include different toxicity, tolerability or physiological characteristics.[Table: see text]