Sociodemographic Factors Influencing Access to Chimeric Antigen T-Cell Receptor Therapy for Patients With Non-Hodgkin Lymphoma

Somya Khare, Staci Williamson, Brittany O'Barr, Levanto Schachter, Andy Chen, Brandon Hayes-Lattin, Jessica Leonard, Amrita Desai, Peter Ferreira-Gandolfo, Kevin Christmas, Denise Lackey, Richard T. Maziarz, Eneida R. Nemecek

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Chimeric antigen receptor T-cell (CAR-T) therapies are available for patients with Non-Hodgkin Lymphoma (NHL); however, their use has been limited in accessibility due to nondisease factors. Patients & Methods: We conducted a retrospective study evaluating the influence of sociodemographic factors on access and outcomes after CAR-T therapy for adult patients with B-cell NHL in our institution treated between 2016 and 2023. Results: Among 154 patients treated with CAR-T, 43% were older than 65 years, 68% male, and 14% non-White (including Hispanic). Of those under 65, 66% had private insurance, while 82% over 65 had Medicare. Most patients (85%) were from in-state, 29% from areas below the national poverty level and 18% from nonmetropolitan areas. Distance to the treatment center was greater than 30, 60 or 120 miles for 52%, 40% and 29% of patients, respectively. No significant differences were found in the use of commercial versus investigational products among racial/ethnic minorities or those living >60 miles from the center. However, patients from nonmetropolitan areas and those below the national poverty level were less likely to receive commercial products. With a median follow-up of 11 months, the 1-year overall survival (OS) was 63.2% (95th CI 59.9%-66.8%). Poverty was associated with lower 1-year OS (HR 0.4, 95th CI 0.17-0.90, P = .031). Conclusion: Our study shows that CAR-T therapy can be delivered across sociodemographic barriers and underscores the importance of considering social determinants of health to optimize access for all patients.

Original languageEnglish (US)
Pages (from-to)e120-e125
JournalClinical Lymphoma, Myeloma and Leukemia
Volume25
Issue number2
DOIs
StatePublished - Feb 2025

Keywords

  • Access
  • CART therapy
  • Cellular therapy
  • Healthcare disparities
  • Non-Hodgkin lymphoma

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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