Age-Related Disparities in ADC Treatment Rates in Breast Cancer with Tabby Khan, MD

Age and insurance status were associated with disproportionate access to antibody-drug conjugate (ADC) treatment among patients with metastatic breast cancer reported in a recent analysis from Komodo Health, a health care intelligence company, and the Tigerlily Foundation, a national breast cancer advocacy organization.

The incidence of metastatic breast cancer cases reported in the US increased from 5.8 per 100,000 women in 2001 to 7.9 per 100,000 women in 2021.2 Furthermore, from 2021 to 2023, ADC treatment rates increased 3.7-fold. During this same period, the median time to treatment also decreased from 331 to 109 days. However, demographic data showed that older women had disproportionately lower rates of treatment (2557 per 100,000) and the longest delays (median, 242 days).3

Contrary to historical cancer care patterns, Black women saw higher rates of treatment when compared with those of White and Asian women, which researchers likely attribute to the higher prevalence of triple-negative breast cancer.3

The analysis, powered by Komodo’s Health Care Map, included a refined subset of 17,005 patients from an initial cohort of 431,276 patients. Treatment rates adjusted by insurance coverage saw a significant difference in commercially insured patients, second to that of Medicaid beneficiaries. Medicare beneficiaries had the lowest rate of treatment.3

“While we've overcome some racial barriers, which I think is extremely positive, I think that this is an example of where we can target older patients a little bit better,” said Tabby Khan, MD, senior director of analytics at Komodo Health, in an interview with The American Journal of Managed Care.® “We have to continue to counsel these patients and also providers on why this may be a really good option for women in that age group.”

Komodo Health layered its platform Marmot on top of its health care map, which has data of over 330 million patients, to quantify disparities on a vast scale.

“I think this was a great example of using this AI platform to really blend all of those things, and in recognition of Breast Cancer Awareness Month,” Khan said.

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References

1. Freckelton E. Komodo health analysis uncovers dual reality in metastatic breast cancer care: rapid targeted cancer therapy adoption amid glaring age-related disparities. Komodo Health. October 20, 2025. Accessed October 29, 2025. https://www.komodohealth.com/press/dual-reality-metastatic-breast-cancer-care-rapid-targeted-cancer-therapy-adoption-amid-glaring-age-related-disparities/

2. Metastatic female breast cancer incidence. Centers for Disease Control and Prevention. November 12, 2024. Accessed October 29, 2025. https://www.cdc.gov/united-states-cancer-statistics/publications/metastatic-breast-cancer.html.

3. Komodo Health; Tigerlily Foundation. ADC treatment patterns in metastatic breast cancer: research brief. New York, NY: Komodo Health; 2025. Accessed October 25, 2025. https://knowledge.komodohealth.com/hubfs/2025/PDFs/Komodo_And_Tigerlily_ADC_Treatment_Patterns_In_Metastatic_Breast_Cancer.pdf