Impact of race and social determinants of health on outcomes in patients with aggressive B-cell NHL treated with CAR-T therapy
Year: 2024
Type: article
Study design: Observational Study
Abstract: ABSTRACT: Chimeric antigen receptor (CAR) T-cell (CAR-T) immunotherapy is an effective therapy for relapsed/refractory B-cell non-Hodgkin lymphoma (r/r B-NHL). However, data are limited on the impact of the convergence of race and social determinants of health on outcomes for patients treated with CAR-T therapy. We examined the impact of interactions between race and insurance type on health care use and outcomes in patients treated with CAR-T therapy for aggressive B-NHL. Adult patients with r/r B-NHL treated with CD19 CAR-Ts were identified between 2015 and 2021 across 13 US academic centers. Insurance type, demographic, and clinical data were collected and analyzed. In total, 466 adult patients were included in our analysis. Median follow-up after CAR-T therapy was 12.7 months. Median progression-free survival (mPFS) was longer for Caucasians (11.5 months) than for African Americans (3.5 months; hazard ratio [HR], 1.56 [1.03-2.4]; P = .04) or Asians (2.7 months; HR, 1.7 [1.02-2.67]; P = .04). Differences in median overall survival (mOS) were not significant. For Medicare (n = 206) vs Medicaid (n = 33) vs private insurance (n = 219) vs self-pay (n = 7): mPFS was 15.9 vs 4.2 vs 6.0 vs 0.9 months (P < .001), respectively; and mOS was 31.2 vs 12.8 vs 21.5 vs 3.2 months (P < .001), respectively. Our multicenter retrospective analysis showed that race and insurance status can affect outcomes for patients treated with CAR-T therapy.
Source: Blood Advances
Authors: Reem Karmali, Rushad Machhi, Narendranath Epperla, Geoffrey Shouse, Jason Romancik, Tamara K. Moyo, Vaishalee Kenkre, Thomas A. Ollila, Lindsey Fitzgerald, Brian Hess, Kevin David, Ishan Roy, Joanna Zurko, Sayan Mullick Chowdhury, Kaitlin Annunzio, Robert Ferdman, Rahul S. Bhansali, Elyse I. Harris, Jieqi Liu, Imran Nizamuddin, Shuo Ma, Jonathan Moreira, Jane Winter, Barbara Pro, Deborah M. Stephens, Alexey Danilov, Nirav N. Shah, Jonathon B. Cohen, Stefan K. Barta, Pallawi Torka, Leo I. Gordon
Institutions: Northwestern University, Robert H. Lurie Comprehensive Cancer Center of Northwestern University, The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, The Ohio State University, City Of Hope National Medical Center, City of Hope, Emory University, Winship Cancer Institute, Levine Cancer Institute, University of Wisconsin–Madison, University of Wisconsin Carbone Cancer Center, Brown University, Lifespan, University of Utah, Huntsman Cancer Institute, Medical University of South Carolina, MUSC Hollings Cancer Center, Rutgers, The State University of New Jersey, Rutgers Cancer Institute, Roswell Park Comprehensive Cancer Center, Shirley Ryan AbilityLab, Hospital of the University of Pennsylvania, University of Pennsylvania, University of North Carolina at Chapel Hill, Medical College of Wisconsin, Medical College of Wisconsin Cancer Center, Memorial Sloan Kettering Cancer Center
Language: English
Topic: CAR-T cell therapy research
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,000
Funders: Eli Lilly and Company, AstraZeneca, Gilead Sciences, Ariad Pharmaceuticals, Celgene, Jazz Pharmaceuticals, TG Therapeutics, MEI Pharma, BeiGene, Incyte, Seagen, Astellas Pharma, MorphoSys, Ipsen, Genentech, Pharmacyclics, Loxo Oncology, National Institute of Diabetes and Digestive and Kidney Diseases, Daiichi Sankyo Europe
Award: G2749247069
OpenAlex ID: W4393188082