{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T17:45:32Z","timestamp":1777484732687,"version":"3.51.4"},"reference-count":57,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100003569","name":"Ministry of Food and Drug Safety","doi-asserted-by":"publisher","award":["21153MFDS601"],"award-info":[{"award-number":["21153MFDS601"]}],"id":[{"id":"10.13039\/501100003569","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003569","name":"Ministry of Food and Drug Safety","doi-asserted-by":"publisher","award":["RS-2024-00331719"],"award-info":[{"award-number":["RS-2024-00331719"]}],"id":[{"id":"10.13039\/501100003569","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Cancer Control"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Despite improved outcomes with PD-1 inhibitors (PD-1i) in advanced non\u2013small cell lung cancer (NSCLC), the determinants of cancer-, cardiovascular disease (CVD)-, and other-cause mortality remain poorly characterized in older adults. This study applies competing-risks methods to estimate cause-specific mortality and to identify predictors for each cause in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study was conducted using the 2014-2019 SEER-Medicare linked database, including patients aged 65 years or older with advanced NSCLC who received PD-1i (nivolumab or pembrolizumab). Mortality outcomes included deaths from CVD, NSCLC, other cancers, and other diseases. Predictors included treatment-related factors (e.g., PD-1i type), demographic factors (e.g., age, sex), socioeconomic status (e.g., Medicaid dual eligibility), cancer-related factors (e.g., NSCLC stage), and comorbidities (e.g., congestive heart failure [CHF]). Competing risk analyses were performed using the Fine-Gray model, with cause-specific Cox models for sensitivity analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 5076 patients, 68.36% received nivolumab and 31.64% received pembrolizumab. Of 3746 deaths, most were from NSCLC (85.34%), while 2.80% were from CVD. No significant difference in CVD mortality risk was observed between the two PD-1i (sub-distribution HR [sHR] = 1.08; 95% CI: 0.63-1.84), but NSCLC mortality was associated with a lower risk in the pembrolizumab group (sHR = 0.67; 95% CI: 0.60-0.74) compared to the nivolumab group. A history of CHF (sHR = 2.10; 95% CI: 1.37-3.21) and Medicaid dual eligibility (sHR = 2.70 vs private insurance; 95% CI: 1.28-5.56) were associated with increased CVD mortality. NSCLC mortality was higher in Stage IV\/distant than in Stage IIIB\/regional (sHR = 1.24; 95% CI: 1.13-1.35) and males (sHR = 1.11; 95% CI: 1.03-1.20).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These results highlight the potential value of integrated cardio-oncology models and strategies addressing socioeconomic inequities among older adults receiving PD-1i. However, conclusions should be tempered by the SEER\u2013Medicare data structure, including lack of biomarker information and restricted applicability to younger or non-Medicare populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10732748251380932","type":"journal-article","created":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T10:41:19Z","timestamp":1759488079000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Factors Associated With Cause-specific Mortality in Older Patients With Advanced NSCLC Treated With PD-1 Inhibitors: A U.S. Population-based Cohort Study"],"prefix":"10.1177","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3183-8477","authenticated-orcid":false,"given":"Yeijin","family":"Kim","sequence":"first","affiliation":[{"name":"College of Pharmacy, Kyung Hee University, Seoul, Republic of Korea"},{"name":"Health Outcomes Division, College of Pharmacy, The University of Texas at Austin, Austin, TX, USA"},{"name":"Institute of Regulatory Innovation Through Science (IRIS), Kyung Hee University, Seoul, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Dell Medical School, The University of Texas at Austin, Austin, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hae Sun","family":"Suh","sequence":"additional","affiliation":[{"name":"College of Pharmacy, Kyung Hee University, Seoul, Republic of Korea"},{"name":"Institute of Regulatory Innovation Through Science (IRIS), Kyung Hee University, Seoul, Republic of Korea"},{"name":"Department of Regulatory Science, Graduate School, Kyung Hee University, Seoul, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1081-0950","authenticated-orcid":false,"given":"Chanhyun","family":"Park","sequence":"additional","affiliation":[{"name":"Health Outcomes Division, College of Pharmacy, The University of Texas at Austin, Austin, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,10,3]]},"reference":[{"issue":"1","key":"e_1_3_7_2_2","first-page":"12","article-title":"Cancer statistics","volume":"74","author":"Siegel RL","year":"2024","unstructured":"Siegel RL, Giaquinto AN, Jemal A. Cancer statistics. CA Cancer J Clin. 2024;74(1):12-49.","journal-title":"CA Cancer J Clin"},{"key":"e_1_3_7_3_2","unstructured":"Institute NC. Lung and bronchus cancer\u2014cancer stat facts. [cited 2024 December 27]; Available from: https:\/\/seer.cancer.gov\/statfacts\/html\/lungb.html"},{"key":"e_1_3_7_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2021.4932"},{"key":"e_1_3_7_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000011936"},{"key":"e_1_3_7_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.13995"},{"key":"e_1_3_7_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)30533-6"},{"key":"e_1_3_7_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(18)30608-9"},{"key":"e_1_3_7_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/cvr\/cvz026"},{"key":"e_1_3_7_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(18)30457-1"},{"key":"e_1_3_7_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacadv.2022.100070"},{"key":"e_1_3_7_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgo.2017.04.001"},{"key":"e_1_3_7_13_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2016.69.0834"},{"key":"e_1_3_7_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00432-017-2522-3"},{"key":"e_1_3_7_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2022.03.042"},{"key":"e_1_3_7_16_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.35.15_suppl.10009"},{"key":"e_1_3_7_17_2","doi-asserted-by":"publisher","DOI":"10.2147\/CMAR.S187317"},{"issue":"8","key":"e_1_3_7_18_2","first-page":"IV3","article-title":"Overview of the SEER-medicare data: content, research applications, and generalizability to the United States elderly population","volume":"40","author":"Warren JL","year":"2002","unstructured":"Warren JL, Klabunde CN, Schrag D, Bach PB, Riley GF. Overview of the SEER-medicare data: content, research applications, and generalizability to the United States elderly population. Med Care. 2002;40(8):IV3-IV18.","journal-title":"Med Care"},{"key":"e_1_3_7_19_2","unstructured":"SEER-Medicare: brief description of the SEER-medicare database. 16 may 2019 [cited 2024 16 Jan]; Available from: https:\/\/healthcaredelivery.cancer.gov\/seermedicare\/overview\/"},{"key":"e_1_3_7_20_2","unstructured":"What is a cancer registry? [cited 2024 16 Jan]; Available from: https:\/\/seer.cancer.gov\/registries\/cancer_registry\/"},{"key":"e_1_3_7_21_2","unstructured":"IRB determination & HIPAA regulations. 2025 [cited 2025 March 12]; Available from: https:\/\/healthcaredelivery.cancer.gov\/seermedicare\/privacy\/hipaa.html"},{"key":"e_1_3_7_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61602-X"},{"key":"e_1_3_7_23_2","unstructured":"Organization WH International statistical classification of diseases and related health problems (10th revision). 2019;[cited 2024 December 28]."},{"key":"e_1_3_7_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8"},{"key":"e_1_3_7_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clgc.2023.08.007"},{"key":"e_1_3_7_26_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciy458"},{"key":"e_1_3_7_27_2","doi-asserted-by":"publisher","DOI":"10.3390\/cancers14020398"},{"key":"e_1_3_7_28_2","doi-asserted-by":"publisher","DOI":"10.1097\/PPO.0000000000000058"},{"key":"e_1_3_7_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.intimp.2017.05.019"},{"key":"e_1_3_7_30_2","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.31136"},{"key":"e_1_3_7_31_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-70207-7"},{"key":"e_1_3_7_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.lungcan.2022.03.020"},{"key":"e_1_3_7_33_2","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2015-0498"},{"key":"e_1_3_7_34_2","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2015-0507"},{"key":"e_1_3_7_35_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00432-019-03079-8"},{"key":"e_1_3_7_36_2","doi-asserted-by":"publisher","DOI":"10.1136\/esmoopen-2018-000344"},{"key":"e_1_3_7_37_2","doi-asserted-by":"publisher","DOI":"10.5761\/atcs.oa.10.01637"},{"key":"e_1_3_7_38_2","doi-asserted-by":"publisher","DOI":"10.3816\/CLC.2004.n.013"},{"key":"e_1_3_7_39_2","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-15-0036"},{"key":"e_1_3_7_40_2","doi-asserted-by":"publisher","DOI":"10.32604\/or.2022.027262"},{"key":"e_1_3_7_41_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.critrevonc.2006.04.001"},{"key":"e_1_3_7_42_2","doi-asserted-by":"publisher","DOI":"10.3390\/cancers12030546"},{"key":"e_1_3_7_43_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2018.79.0006"},{"key":"e_1_3_7_44_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2018.06.004"},{"key":"e_1_3_7_45_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.19.00189"},{"key":"e_1_3_7_46_2","unstructured":"Diana A Rudowitz R Tolbert J. A look at navigating the health care system: medicaid consumer perspectives. KFF."},{"key":"e_1_3_7_47_2","volume-title":"Dual-Eligible Beneficiaries of Medicare and Medicaid: Characteristics, Health Care Spending, and Evolving Policies","author":"Office CB","year":"2013","unstructured":"Office CB. Dual-Eligible Beneficiaries of Medicare and Medicaid: Characteristics, Health Care Spending, and Evolving Policies. Washington, DC: Congressional Budget Office; 2013."},{"key":"e_1_3_7_48_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2016.2724"},{"issue":"2","key":"e_1_3_7_49_2","first-page":"4","article-title":"The high cost-related medication non-adherence rate among medicare-medicaid dual-eligible diabetes patients","volume":"2","author":"Zhang JX","year":"2016","unstructured":"Zhang JX, Meltzer DO. The high cost-related medication non-adherence rate among medicare-medicaid dual-eligible diabetes patients. J Health Med Econ. 2016;2(2):4-5.","journal-title":"J Health Med Econ"},{"key":"e_1_3_7_50_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.27380"},{"key":"e_1_3_7_51_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.33207"},{"key":"e_1_3_7_52_2","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2021.7083"},{"issue":"55","key":"e_1_3_7_53_2","first-page":"3","article-title":"Updated overview of the SEER-medicare data: enhanced content and applications","volume":"2020","author":"Enewold L","year":"2020","unstructured":"Enewold L, Parsons H, Zhao L, et al. Updated overview of the SEER-medicare data: enhanced content and applications. JNCI Monographs. 2020;2020(55):3-13.","journal-title":"JNCI Monographs"},{"key":"e_1_3_7_54_2","unstructured":"Measures that are limited or not available in the data. 2025 [cited 2025 March 12]; Available from: https:\/\/healthcaredelivery.cancer.gov\/seermedicare\/considerations\/measures.html#2"},{"key":"e_1_3_7_55_2","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000001974"},{"key":"e_1_3_7_56_2","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2016.0031"},{"key":"e_1_3_7_57_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2015.62.1342"},{"key":"e_1_3_7_58_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2012.09.017"}],"container-title":["Cancer Control"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10732748251380932","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10732748251380932","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10732748251380932","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T14:24:03Z","timestamp":1777386243000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10732748251380932"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9]]},"references-count":57,"alternative-id":["10.1177\/10732748251380932"],"URL":"https:\/\/doi.org\/10.1177\/10732748251380932","relation":{"has-review":[{"id-type":"doi","id":"10.1177\/10732748251380932\/v2\/review2","asserted-by":"object"},{"id-type":"doi","id":"10.1177\/10732748251380932\/v2\/response1","asserted-by":"object"},{"id-type":"doi","id":"10.1177\/10732748251380932\/v2\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1177\/10732748251380932\/v1\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1177\/10732748251380932\/v1\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1177\/10732748251380932\/v1\/review2","asserted-by":"object"},{"id-type":"doi","id":"10.1177\/10732748251380932\/v1\/review3","asserted-by":"object"},{"id-type":"doi","id":"10.1177\/10732748251380932\/v2\/decision1","asserted-by":"object"}]},"ISSN":["1073-2748","1526-2359"],"issn-type":[{"value":"1073-2748","type":"print"},{"value":"1526-2359","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9]]},"article-number":"10732748251380932"}}