Abstract
PURPOSE: Social determinants of health (SDOH) are associated with disparities not only in risk factors, screening, diagnosis, and treatment outcomes for cancer but also in access to immunotherapy treatment, particularly with immune checkpoint inhibitors (ICIs). The purpose of this systematic review was to describe the extent of inclusion of indicators of SDOH in studies using PROMs to assess toxicities associated with ICI treatment. METHODS: PubMed, EMBASE, MEDLINE, PsycINFO, CINAHL, Web of Knowledge, and the Cochrane Library were searched for papers using patient-reported outcomes measures (PROMs) to assess toxicities in ICI treatment until October 2024. RESULTS: A total of 43 studies were included after applying the inclusion criteria, with the majority being RCTs (n = 20). SDOH features were extracted using the PROGRESS-Plus framework. The most frequently reported PROGRESS-Plus factors were residence (100%; 43/43), age (100%; 43/43), and gender (97.7%; 42/43). Race/ethnicity was included in 16 studies (37.2%) and education in 11 (25.6%). Very few studies reported socioeconomic status (11.6%; 5/43), social capital (9.3%; 4/43), and occupation (9.3%; 4/43). None of the studies included information on religion, disability, and sexual orientation. CONCLUSION: Collection and consideration of SDOH in studies using PROMs to assess toxicities in ICI treatment in cancer care are limited. Reported SDOH are not sufficient as they overlook important characteristics such as religion, disability, and sexual orientation. Improved accuracy and details are essential in understanding the needs of various populations. Availability of these data will facilitate understanding of health inequalities and prompt action to address avoidable disparities in health, improving outcomes for all.