Population-based study of rates of systemic treatment for metastatic non-small cell lung cancer among older adults

Metastatic non-small cell lung cancer (mNSCLC) has high mortality rates. Highly effective and better tolerated treatments have become available in recent decades Nevertheless, population-level treatment of mNSCLC is poorly defined. A population-based study using SEER and Medicare claims data investigated treatment rates, trends, and factors associated with treatment of mNSCLC in US patients aged 65 years and older diagnosed from 2006 through 2021. Among 254 611 patients, the median age was 73 years (IQR 68-80); 52.5% were males. A total of 119 197 patients (46.8%) ever received systemic treatment. Of the 100 367 (39.8%) who died within 90 days from diagnosis, 13.2% were treated compared with 69% of those surviving more than 90 days. The treated proportion increased only slightly between 2006 and 2021. Other factors associated with receipt of treatment included referral to an oncologist, adenocarcinoma histology, low comorbidity burden, and being married. The authors conclude that despite the availability of more effective and better tolerated treatments, about half of patients with mNSCLC never received systemic therapy, and treatment rates changed minimally over time.