Understanding Physician Referral for Chimeric Antigen Receptor T-Cell (CAR-T) Therapy

Chimeric antigen receptor t-cell (CAR T) therapy is a promising treatment option for patients with various types of leukemia and lymphoma, yet little is known about oncologists' attitudes, knowledge, and referral patterns for this therapy. Our goal was to identify potential gaps in Florida oncologists' attitudes, knowledge, and referral patterns for CAR T in patients with diffuse large b-cell lymphoma, transformed follicular lymphoma, primary mediastinal b-cell lymphoma, and acute lymphoblastic leukemia. Oncologists and Hematologists in Florida were identified from the American Medical Association's Physician Masterfile (n=771) and invited to complete a survey measuring attitudes and knowledge about CAR T and referral patterns between August 2020-October 2020. We received 67 completed surveys (10% response rate). Results were quantified using descriptive statistics. Of those who completed surveys, physicians in our study indicated moderate confidence in CAR T efficacy (49.2%), toxicity (53.8%), and indications (60%). Physicians reported frequently discussing CAR T with patients (59.4%) and indicated experiencing patient concerns about safety/toxicity of CAR T (31.7%) and concerns about cost/insurance coverage (39.7%). Educational materials are not frequently utilized by physicians when discussing CAR T with patients; 73% indicated they never/rarely have materials available at clinic visits. Our study is among the first to assess oncologist's attitudes, knowledge, and referral patterns of CAR T therapy for patients with diffuse large B-Cell Lymphoma. Efforts are needed to educate community oncologists about CAR T and develop educational materials for patients to aid in decision making about CAR T therapy and improve physician confidence and referral patterns.