Researchers assessed barriers to chimeric antigen receptor (CAR) T-cell therapy for patients with non-Hodgkin lymphoma (NHL) in a community-based network and found that 41% of patients did not receive “timely access” to treatment.
The study was led by Minoo Battiwalla, MD, of Sarah Cannon Cancer Network, and published in Blood Advances.
Researchers assessed 357 patients from a community-based transplant and cell therapy network registry who were approved for anti-CD19 CAR-T therapy between 2018 and 2022; 306 patients were included in the final analysis: 182 received CAR-T and 124 did not.
Median age at referral was 61 years, and most patients (69%) had diffuse large B-cell lymphoma.
Among patients who received CAR-T, they were treated with axicabtagene ciloleucel (62%), tisagenlecleucel (16%), brexucabtagene autoleucel (13%), and lisocabtagene maraleucel (9%).
Median time from:
- Referral to consultation was 11 days
- Consultation to apheresis was 107 days
- Collection to infusion was 32 days
The researchers highlighted that the median duration from consultation to CAR-T infusion declined steadily from 207 days in 2019 to 108 days in 2022 (P<.0001). The proportion of ineligible patients also declined from 53% in 2018 to 2020 to 34% by 2021 to 2022 (P=.001).
The researchers indicated that demographic, financial, or social determinants did not influence whether or not a patient received CAR-T.
The researchers indicated that the following strategies could impact access:
- Reducing time to apheresis
- Early referral
- Attention to salvage/bridging strategies
The study is limited by its lack of granular data on the number of prior lines of therapy and choice of prebridging and/or bridging therapy, which the authors said are “highly relevant to access.”
Reference
Battiwalla M, Tees M, Flinn I, et al. Access barriers to anti-CD19+ CART therapy for NHL across a community transplant and cellular therapy network. Blood Adv. 2025;9(2):429-435. doi:10.11822/bloodadvances.2024014171
