Minorites less likely to receive liver cancer treatment

June 8, 2022

A new study from Cedars-Sinai Cancer shows that Black and Hispanic patients are less likely to receive the most effective treatment for liver cancer.

Racial and ethnic minorities diagnosed with advanced liver cancer have a lower chance of receiving immunotherapy, the most effective treatment for patients with the disease, according to a new study led by Cedars-Sinai Cancer investigators.

The study, published in the peer-reviewed journal Hepatology, found Black and Hispanic patients were significantly less likely to receive immunotherapy compared with white patients, even though the researchers found immunotherapy to be more effective than the traditional treatment of chemotherapy for advanced-stage liver cancer in a wider patient population.

In recent years, immunotherapy using immune checkpoint inhibitors has revolutionized the treatment of many cancers, including liver cancer.

The immunotherapy combination—atezolizumab-bevacizumab—was approved in 2020 as a first-line therapy for patients with advanced liver cancer. The clinical trial that led to the Food and Drug Administration approval showed that the therapy not only improved the overall survival and reduced the risk of death by 42%, but the percentage of patients whose cancer shrank or disappeared more than doubled.

“Although it is very encouraging to see the effectiveness of this promising treatment outside of clinical trials in a broader population, it is very unfortunate to see that Black and Hispanic patients have a lower chance of receiving such an effective treatment for their cancer,” said Ju Dong Yang, MD, medical director of the Liver Cancer Program at Cedars-Sinai Cancer and senior author of the study.

Historically, racial and ethnic minorities have been underrepresented in clinical trials and experimental treatments for cancer. As with other therapies, there is also a concern for potential racial-ethnic disparities in early access to immunotherapy among patients with liver cancer in the United States.

To investigate the potential disparities and the effectiveness of immunotherapy for advanced liver cancer, Yang and his team used the U.S. National Cancer Database to review medical records and outcome data from 3,990 patients with stage 3 or stage 4 liver cancer.

They found 3,248 of the patients were treated with chemotherapy and 742 were treated with immunotherapy. During the study period, however, the annual proportion of patients receiving immunotherapy steadily increased.

Cedars Sinai release