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Prevalence of Targetable Mutations in Black Patients With Lung Cancer: A Systematic Review and Meta-Analysis

Prevalence of Targetable Mutations in Black Patients With Lung Cancer: A Systematic Review and Meta-Analysis

Source :

https://ascopubs.org/doi/10.1200/OP.20.00961

PURPOSE: Inferior outcomes of Black patients with lung cancer compared with other racial groups are often linked to socioeconomic factors. It is crucial to determine whether a varying prevalence of targetable mutations limits treatments and contributes to disparities.

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    Key Points
    • In the current meta-analysis, researchers determined the prevalence of lung cancer EGFR, ALK, ROS-1, and BRAF mutations in Black patients. They compared these results with White, Asian, and Hispanic patients.
    • “Inferior outcomes of Black patients with lung cancer compared with other racial groups are often linked to socioeconomic factors. It is crucial to determine whether a varying prevalence of targetable mutations limits treatments and contributes to disparities,” the authors wrote.
    • The authors found a lower prevalence of EGFR mutations in Black patients compared with that of other races, as well as a low overall occurrence of ALK, ROS-1, and BRAF mutations. With few driver mutations present, Black patients are less frequently candidates for targeted therapies, thus heightening disparities and gaps in clinical outcomes.
    • “Greater enrollment of Black patients in clinical trials, universal access to molecular testing, and further research on the unique tumor characteristics and therapeutic strategies for Black patients are urgently needed,” the authors wrote. The authors also cited structural racism as a major contributor.. Structural racism presents as social, historical, and economic disparities.
    • Limitations of the current study include selection bias due to the overestimation of mutations because patients with a higher chance of having a mutation are more likely to be tested. Another limitation is that because most of the studies assessed were performed in the United States, it is hard to generalize results to other Black populations. Another limitation is that race was self-reported. On a related note, all Hispanic patients were grouped together as a race. Finally, a paucity of reporting on mutation by histology compromised stratification.