Conference Abstracts - 5th Binaytara Precision Oncology Summit: Redefining Cancer Treatment with Molecular Targeted Strategies
Vol. 5, Issue Supplement 1, 2025 · S1-2
Race/ethnicity associated clinicogenomic, socioeconomic, and environmental predictors in metastatic non-small cell lung cancer (mNSCLC) treated with immunotherapy
Nirosha Perera King, M.D.,Lingzhi Hong, MD PHD,Dawen Sui, MS,Waree Rinsurongkawong, PHD,Elliana Young, MS,Mehmet Altan, MD,John Lin, MD MSHP,Jianjun Zhang, MD PHD
Submission received: 2025-08-02 / Accepted: 2025-08-27 / Published: 2025-09-26
BACKGROUND
PD-L1 low and STK11 mutations are associated with immune checkpoint inhibitor (ICI) resistance in non-small cell lung cancer (NSCLC). Higher Social Deprivation Index (SDI) associates with worse survival in nonmetastatic breast/prostate/colorectal and lung cancer. PM2.5 (particulate matter with a diameter ≤2.5 µm) and NO₂ (nitrogen dioxide) are both major components of air pollution, and substantial evidence links their exposure to the development and progression of NSCLC via DNA damage and chronic airway inflammation. It is unclear whether socioeconomic and environmental risk factors, and clinicogenomic predictors differ by race/ethnicity in metastatic NSCLC treated with ICI.
METHODS
We retrospectively studied NSCLC patients 18 or older, without targetable EGFR or ALK alterations, treated with frontline combination chemotherapy with ICI (ICI-chemo) or ICI monotherapy (ICI-mono) between January 2014 and February 2020 at MD Anderson Cancer Center. Associations between race/ethnicity and each variable were assessed via Fisher's exact tests, Chi-squared tests, or Kruskal-Wallis tests. Odds ratios calculated via logistic and multinomial logistic regression.
RESULTS
After excluding those with missing demographic data and excluding native Alaskan/Hawaiian/American Indian race/ethnicity due to low sample size for this racial/ethnic group, 1529 patients were included for analysis. Prevalence of STK11, TP53, & KRAS mutations differed significantly by race/ethnicity (Table 1), as did social deprivation index (SDI) scores and environmental exposures (Figure 1), with minority patients having higher rates of known poor prognostic factors.
FIGURE 1. Odds ratios for poor prognostic factors my race/ethnicity.
TABLE 1. Frequency of key clinical, molecular, socioeconomic, and environmental risk factors by race/ethnicity.
CONCLUSION
Compared to White patients, Black/African American and Hispanic/Latino (HL) patients had statistically significant higher odds of underweight BMI, neighborhood disadvantage, Texas residence, higher NO2 and PM2.5 exposures, poor ECOG PS, and TP53 mutation, despite lower odds of heavy smoking.
Compared to White patients, Black, HL, and Asian patients had statistically significant lower odds of KRAS mutation, higher Ozone exposure, and heavy smoking.