TACTUM: Trends in Access to Cellular Therapies in Multiple Myeloma, Perspectives of Treating Versus Referring Physicians

•Barriers perceived by treating/referring oncologists TO/RO for CART and TCE differ.•Financial burden was the top barrier to access identified by RO for both CART and TCE.•Limited slot availability was the top barrier to CART access identified by TO.•Hospitalization requirements were the top barrier...

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Published in:	Transplantation and cellular therapy Vol. 30; no. 9; pp. 925.e1 - 925.e6
Main Authors:	Atallah, Rawan, Ahmed, Nausheen, Ayoobkhan, Fathima, Saif, Md Saiful Islam, Logan, Emerson, Shrestha, Anuj, Anwer, Faiz, Mahmoudjafari, Zahra, Mushtaq, Muhammed Umair, Hashmi, Hamza, Ganguly, Siddhartha, McGuirk, Joseph, Shebli, Atrash, Abdallah, Al-Ola, Banerjee, Rahul, Alkharabsheh, Omar
Format:	Journal Article
Language:	English
Published:	United States Elsevier Inc 01-09-2024
Subjects:	Barriers Bispecific T cell engagers (TCE) Chimeric antigen receptor T cell therapies (CART) Multiple myeloma treating oncologists, Multiple myeloma referring oncologists Multiple myeloma treatment access Multiple myeloma treatment access Chimeric antigen receptor T cell therapies (CART) Bispecific T cell engagers (TCE) Barriers Multiple myeloma treating oncologists, Multiple myeloma referring oncologists
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Summary:	•Barriers perceived by treating/referring oncologists TO/RO for CART and TCE differ.•Financial burden was the top barrier to access identified by RO for both CART and TCE.•Limited slot availability was the top barrier to CART access identified by TO.•Hospitalization requirements were the top barrier to TCE access identified by TO.•Opportunities needed to raise RO awareness about financial support for CART/ TCE. Chimeric antigen receptor T cell therapy (CAR-T) and bispecific T cell engagers (TCE) for multiple myeloma (MM) are readily available at many large US medical centers. However, many potentially eligible patients may not be referred to the specialized centers administering these therapies. Perspectives regarding potential barriers for MM cellular therapy from referring-center oncologists (ROs) versus treating-center oncologists (TOs) have not been reported previously. We conducted TACTUM-23, a survey of US oncologists who treat MM, to identify perceived barriers to these cellular therapies. This 24-question survey, which focused on demographics and perceived barriers to CAR-T and TCE, was conducted between June and August 2023. Of 247 oncologists, 37 (15%) completed the survey including 26 (70%) TOs who prescribed both CAR-T and TCEs, 4 (11%) TOs who only prescribed TCEs, and 7 (19%) ROs who referred patients. The top RO-stated barrier to CAR-T was financial toxicity, while the top TO-stated barrier to CAR-T was leukapheresis/ manufacturing slot availability. The top RO-stated barrier to TCE was financial toxicity, while the top TO-stated barrier to TCE was the hospitalization requirement. In conclusion, financial concerns are perceived by ROs to be the top barrier to both CAR-T and TCEs in myeloma. In contrast, TOs perceive logistical concerns to be the top barrier. Interventions to lower financial toxicity during these therapies, and outreach to raise awareness of such interventions among ROs, are needed alongside strategies to streamline manufacturing (for CAR-T) and monitoring.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	2666-6367 2666-6367
DOI:	10.1016/j.jtct.2024.05.011