Investigating CAR-T Treatment Access for Multiple Myeloma Patients Using Real-World Evidence

Area of Science:

• Hematologic Malignancies
• Immunotherapy

Background:

• Multiple myeloma (MM) is a significant hematologic malignancy with higher incidence in Black patients.
• Chimeric antigen receptor T-cell (CAR-T) therapy offers promise but faces access challenges.

Purpose of the Study:

• To investigate factors associated with CAR-T therapy receipt in MM patients.
• To examine the impact of disease characteristics, treatment site, and demographics on CAR-T therapy access.

Main Methods:

• Retrospective cohort study of 12,360 MM patients using electronic health records (2021-2025).
• Logistic regression analyzed associations between demographics, disease stage, and CAR-T receipt.
• Zero-shot GPT-4 model assessed CAR-T discussion and eligibility from clinical notes.

Main Results:

• Only 2.6% of MM patients received CAR-T therapy.
• Black patients had significantly lower odds of receiving CAR-T therapy compared to White patients (OR 0.33).
• Disparities in documented CAR-T discussions were observed among eligible patients across racial groups.

Conclusions:

• CAR-T therapy receipt in MM varies by treatment location and patient race within a large health system.
• Potential disparities in referral, documentation, or care pathways may influence CAR-T therapy access for certain patient groups.