Gynecologic oncology
October 16, 2026 · via Europe PMC
Trends in immunotherapy utilization among older adults with advanced endometrial cancer: An NCDB analysis.
Assavapokee N, Gellman C, Blank SV, Carr C
AI summary — for doctors, generated from the abstract only
Immunotherapy use for advanced endometrial cancer rose over time, but older adults and Black patients were less likely to receive it.
What was studied
A retrospective National Cancer Database cohort of women with stage III-IV endometrial cancer diagnosed 2019-2023, examining temporal trends in immunotherapy use and predictors using multivariable logistic regression, with a focus on women aged 65 and older.
Key findings
- Of 38,931 patients with advanced disease, 21,272 (54.6%) were aged 65 or older
- Immunotherapy use increased significantly over time across all age groups
- Substantial age-based disparities persisted
- Non-Hispanic Black patients were less likely to receive immunotherapy than non-Hispanic White patients, even after socioeconomic adjustment
Clinical relevance
The findings point to possible inequities in access to effective therapy and a need to look at clinical, socioeconomic and structural barriers.
Who should care
Limitations
The abstract is cut off, so trend statistics and odds ratios are missing. The NCDB lacks details such as molecular subtype, performance status and reasons for not treating, so appropriate non-use cannot be separated from inequity.
Uptake is growing, but age and racial disparities warrant investigation.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
OBJECTIVE
To examine temporal trends in immunotherapy (IO) adoption and identify factor-related disparities among older adults with advanced endometrial cancer (EC).
METHODS
We conducted a retrospective cohort study using the National Cancer Database (NCDB), including women aged ≥65 years diagnosed with stage III-IV EC between 2019 and 2023. Temporal trends of IO use were assessed, and multivariable logistic regression identified predictors of IO utilization.
RESULTS
Among 38,931 patients with advanced EC, 21,272 (54.6%) were aged ≥65 years. IO utilization increased significantly over time across all age groups (P-trend <0.001). By 2023, 1851 older adults (40%) received IO, but utilization remained substantially lower among patients aged ≥85 years (55/255, 21.6%; P < 0.001). On multivariable analysis, patients aged ≥85 years were significantly less likely to receive IO compared with those aged 65-74 years (adjusted odds ratio [aOR] 0.41; 95% CI, 0.32-0.52; P < 0.001). Non-Hispanic (NH)-Black (aOR 0.81; 95% CI, 0.73-0.90; P < 0.001) and Hispanic patients (aOR 0.84; 95% CI, 0.71-0.99; P = 0.034) were also less likely to receive IO compared with NH-White patients. After adjustment for socioeconomic factors, NH-Black was 12% less likely to receive IO (aOR 0.88; 95% CI, 0.77-0.99; P = 0.0034).
CONCLUSION
Despite the proven clinical benefit of IO use for patients with advanced EC, substantial age-based disparities persist. A lower likelihood of IO receipt among NH-Black compared with NH-White patients was also observed even after adjustment for socioeconomic factors. These findings highlight the need for further investigation into clinical, socioeconomic, and structural barriers influencing treatment access in older and minoritized populations.
DOI
10.1016/j.ygyno.2026.10.010
PMID
42887398
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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