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Widening demographic gaps in CAR-T therapy utilization for multiple myeloma in the United States

Bone Marrow Transplantation volume 58, pages 1400–1402 (2023)Cite this article

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Chimeric Antigen Receptor T-cell (CAR-T) therapy is a promising anti-multiple myeloma (MM) treatment option. Based on results from clinical trials of patients in relapsed/refractory MM [1, 2] two CAR-T therapies have been FDA-approved: idecabtagene vicleucel in 3/2021 and ciltacabtagene autoleucel in 2/2022. Evidence suggests that novel therapies often result in socioeconomic and racial disparities in access [3]. With the promise of superior MM control with CAR-T therapy, it is important to ensure equitable access to the treatment for all patients.

A small but growing body of literature suggests racial disparities in the utilization of CAR-T [4, 5]. As of December 2022, Public Law 117–328 was enacted by the US Federal Drug Administration requiring clinical trials to include diversity action plans in order to ensure better representation of the national population. However, once a drug is approved, there are few, if any, mechanisms in place to enforce equitable access. We sought to explore differences in CAR-T therapy utilization by age, sex, race, and ethnicity using a large and representative dataset.

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Acknowledgements

Research reported in this publication was supported by a grant funded by the MCW Collaborative for Healthcare Delivery Science (AD). The content is solely the responsibility of the authors and does not necessarily represent the official views of the funder. The TriNetX data reported here have been supplied by the Medical College of Wisconsin Clinical Research Data Warehouse. The interpretation and reporting of these data are the responsibility of the author(s) and in no way should be seen as an official policy of or interpretation by the Medical College of Wisconsin.

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Authors and Affiliations

  1. Medical College of Wisconsin (MCW) Medical School, Milwaukee, WI, USA

    Mingqian Lin

  2. Division of Hematology/Oncology, Department of Medicine, MCW, Milwaukee, WI, USA

    Noel Estrada-Merly, Mary Eapen, Anthony E. Zamora, William R. Drobyski & Anita D’Souza

  3. Institute of Health and Safety, MCW, Milwaukee, WI, USA

    Liliana E. Pezzin

  4. MCW Pharmacy School, Milwaukee, WI, USA

    Aaron N. Winn

  5. ThedaCare Regional Cancer Center, Appleton, WI, USA

    Joyce Philip

  6. Division of Hematology/Oncology, Department of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA

    Carolina Schinke

  7. Department of Internal Medicine, University of Texas Southwestern, Dallas, TX, USA

    Larry D. Anderson Jr.

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  1. Mingqian Lin
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  10. Larry D. Anderson Jr.
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  11. Anita D’Souza
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Contributions

All authors contributed toward study design, analysis, review of findings, and manuscript writing.

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Correspondence to Anita D’Souza.

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Competing interests

ML, NE, ME, LEP, ANW, JP, WD report no conflicts of interest relevant to this work. AEZ reports research support from PhenomeX not related to the data presented in the current study. CS reports Consulting/Advisory Board activity with Janssen and Pfizer. LA reports Consulting/Advisory Board activity with: Janssen, Celgene, BMS, Amgen, GSK, AbbVie, Beigene, Cellectar, Sanofi, Prothena; AD reports institutional research funding from Abbvie, Caelum, Janssen, Novartis, Prothena, Sanofi, Sorrento, TeneoBio, consulting/advisory board activity with BMS, Janssen, Pfizer, Prothena.

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Lin, M., Estrada-Merly, N., Eapen, M. et al. Widening demographic gaps in CAR-T therapy utilization for multiple myeloma in the United States. Bone Marrow Transplant 58, 1400–1402 (2023). https://doi.org/10.1038/s41409-023-02102-4

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