Revision History

A major JAMA Oncology study of more than 250,000 older adults diagnosed with metastatic non-small cell lung cancer between 2006 and 2021 found that roughly half never received systemic treatment — a rate that barely changed over 15 years despite the arrival of immunotherapy and targeted agents shown to extend survival by years. The findings expose deep fault lines in the U.S. cancer care system: 40% of patients died within 90 days of diagnosis, biomarker testing rates remain sharply unequal across racial and insurance lines, and many patients never saw an oncologist at all.