KEY TAKEAWAYS
- The study examined whether people in MHPs have equal access to CART19 and similar outcomes as non-minority groups.
- The study found MHPs maintained access to LBCL care but had reduced access to CART19 immunotherapy.
The administration of anti-CD19 chimeric antigen receptor T-cell (CART19) immunotherapy for large B-cell lymphomas (LBCLs), a type of non-Hodgkin lymphoma (NHL), involves high costs and requires access to specialized tertiary care centers.
Guido Ghilardi and the team aimed to evaluate whether minority health populations (MHPs) have equal access to CART19 immunotherapy and if their outcomes are comparable to those of non-MHPs.
The prevalence and clinical outcomes of patients treated with commercial CART19 were analyzed at 2 institutions that were the Abramson Cancer Center (ACC) in Philadelphia, Pennsylvania, and the Knight Cancer Institute (KCI) in Portland, Oregon.
The results revealed that in the ACC catchment area, 8956 patients were diagnosed with NHL between 2015 and 2019, with 17.9% identified as MHPs. Among patients with LBCL treated at ACC between 2018 and 2022 (following CART availability in 2018), 1492 received treatment, with 194 receiving CART19. MHPs constituted 15.7% of the entire LBCL cohort but only 6.7% of the CART19 cohort.
Similarly, in the KCI catchment area, 4568 patients were diagnosed with NHL, with 4.2% identified as MHPs. Among patients with LBCL treated at KCI, 396 received treatment, with 47 receiving CART19. MHPs represented 6.6% of the entire LBCL cohort and 4.2% of the CART19 cohort. The analysis of 3-month response, survival, and toxicities post-CART19 infusion showed similar outcomes despite the limited number of treated patients.
The study indicated that MHPs’ access to tertiary centers for LBCL care remained intact but appeared diminished for commercial CART19 immunotherapy. Although clinical outcomes for MHPs appeared comparable to those of non-MHPs, the limited sample size prevents definitive conclusions. Further research is warranted.
Funding was provided by the Laffey McHugh Foundation, and others.
Source: https://pubmed.ncbi.nlm.nih.gov/38776868/
Ghilardi G, Williamson S, Pajarillo R, et al. (2024). “CAR T-Cell Immunotherapy in Minority Patients with Lymphoma.” NEJM Evid. 2024 Apr;3(4):EVIDoa2300213. doi: 10.1056/EVIDoa2300213. Epub 2024 Mar 26. PMID: 38776868.
