Dr Ruella on Improving Access to CAR T-Cell Therapy for Minority Populations in Multiple Myeloma

"We need to act both on the patient side and the healthcare provider side, in the sense that we need to educate providers to be aware of potential unconscious biases. At the same time, we also need to [ask ourselves:] does the patient have the knowledge about the treatment? Are we addressing the potential concerns that might be well-founded? Are we helping to making this therapy feasible [for them]?"

Marco Ruella, MD, assistant professor, medicine (hematology-oncology), Perelman School of Medicine; scientific director, Lymphoma Program, the Hospital of the University of Pennsylvania, discusses the implications of findings from a retrospective study evaluating access to and outcomes with commercial BCMA-targeted CAR T-cell therapy for the management of multiple myeloma in minority health populations.

A retrospective study compared access to BCMA-targeted CAR T-cell therapy among minority health populations and their outcomes with that of nonminority populations, Ruella details. The study evaluated 3 cohorts of patients with multiple myeloma from the Abramson Cancer Center: the catchment area cohort (3217 patients), the Abramson multiple myeloma cohort (1747 patients), and the BCMA-targeted CAR T-cell cohort, which comprised 122 patients treated with commercial CAR T-cell therapy.

Results revealed a progressive reduction in the percentage of minority health population patients as the cohort narrowed from the general catchment area to those receiving BCMA-targeted CAR T-cell therapy. This suggests that although minority health populations generally have access to tertiary care for multiple myeloma, their access to commercial CAR T-cell therapy is significantly diminished, particularly for those residing outside the catchment area. However, when patients in minority health populations received BCMA-targeted CAR T-cell therapy, their survival and safety outcomes were similar to those of nonminority patients.

The findings underscore the importance of systematically recording data related to the socioeconomic status, race, and ethnicity of patients, Ruella states, adding that accurate and comprehensive databases will help provide a clearer snapshot of health disparities in the treatment of multiple myeloma. Addressing these disparities requires action on both the health care provider and patient sides, he emphasizes. Health care providers must be educated to recognize and mitigate unconscious biases that may affect treatment decisions, ensuring that therapies are offered based on measurable data rather than assumptions tied to a patient’s background, he says.

On the patient side, it is crucial to ensure that individuals are well-informed about treatment options and that their concerns are addressed, Ruella continues. Efforts should also be made to make therapies more feasible, such as providing assistance with transportation or covering out-of-pocket expenses, he adds. Collaborative initiatives are essential in implementing prospective solutions to address these challenges, ultimately promoting more equitable access to cutting-edge therapies like BCMA-targeted CAR T-cell therapy, Ruella concludes.