Disparities in immune and targeted therapy utilization for older US patients with metastatic renal cell carcinoma.

Disparities in metastatic renal cell carcinoma (mRCC) outcomes persist in the era of oral anticancer agents (OAAs) and immunotherapies (IOs). We examined variation in the utilization of mRCC systemic therapies among US Medicare beneficiaries from 2015-2019. Logistic regression models evaluated the association between therapy receipt and demographic covariates including patient race, ethnicity and sex. In total, 15,407 patients met study criteria. After multivariable adjustment, non-Hispanic Black race and ethnicity was associated with reduced IO (adjusted relative risk ratio (aRRR) = 0.76 [0.61-0.95]; P = 0.015) and OAA receipt (aRRR = 0.76 [0.64-0.90]; P = 0.002) compared to non-Hispanic White race and ethnicity. Female sex was associated with reduced IO (aRRR = 0.73 [0.66-0.81]; P < 0.001) and OAA receipt (aRRR = 0.74 [0.68-0.81]; P < 0.001) compared to male sex. Thus, disparities by race, ethnicity, and sex were observed in mRCC systemic therapy utilization for Medicare beneficiaries from 2015-2019.