Impact of race and social determinants of health on outcomes in patients with aggressive B-cell NHL treated with CAR-T therapy

被引：12

作者：

Karmali, Reem ^{[1
,15
]}

Machhi, Rushad ^{[2
]}

Epperla, Narendranath ^{[3
]}

Shouse, Geoffrey ^{[4
]}

Romancik, Jason ^{[5
]}

Moyo, Tamara K. ^{[6
]}

Kenkre, Vaishalee ^{[7
]}

Ollila, Thomas A. ^{[8
]}

Fitzgerald, Lindsey ^{[9
]}

Hess, Brian ^{[10
]}

David, Kevin ^{[11
]}

Roy, Ishan ^{[12
]}

Zurko, Joanna ^{[7
]}

Chowdhury, Sayan Mullick

Annunzio, Kaitlin ^{[3
]}

Ferdman, Robert

Bhansali, Rahul S. ^{[13
]}

Harris, Elyse I. ^{[7
]}

Liu, Jieqi ^{[11
]}

Nizamuddin, Imran ^{[1
]}

Ma, Shuo ^{[1
]}

Moreira, Jonathan ^{[1
]}

Winter, Jane ^{[1
]}

Pro, Barbara ^{[1
]}

Stephens, Deborah M. ^{[9
]}

Danilov, Alexey ^{[4
]}

Shah, Nirav N. ^{[14
]}

Cohen, Jonathon B. ^{[5
]}

Barta, Stefan K. ^{[13
]}

Torka, Pallawi ^{[12
]}

Gordon, Leo I. ^{[1
]}

机构：

[1] Northwestern Univ, Robert H Lurie Comprehens Canc Ctr, Chicago, IL USA

[2] Northwestern Univ, Feinberg Sch Med, Chicago, IL USA

[3] Ohio State Univ, Arthur G James Canc Hosp, Columbus, OH USA

[4] Ohio State Univ, Richard J Solove Res Inst, Columbus, OH USA

[5] City Hope Comprehens Canc Ctr, Duarte, CA USA

[6] Emory Univ, Winship Canc Inst, Atlanta, GA USA

[7] Atrium Hlth Levine Canc Inst, Charlotte, NC USA

[8] Univ Wisconsin, Carbone Canc Ctr, Madison, WI USA

[9] Brown Univ, Lifespan Canc Inst, Providence, RI USA

[10] Univ Utah, Huntsman Canc Inst, Salt Lake City, UT USA

[11] Med Univ South Carolina, Hollings Canc Ctr, Charleston, SC USA

[12] Roswell Park Comprehens Canc Ctr, Buffalo, NY USA

[13] Univ Penn, Abramson Canc Ctr, Philadelphia, PA USA

[14] Med Coll Wisconsin, MCW Canc Ctr, Milwaukee, WI USA

[15] Northwestern Univ, Feinberg Sch Med, Div Hematol & Oncol, 676 N St Clair St,Suite 850, Chicago, IL 60611 USA

来源：

BLOOD ADVANCES | 2024年 / 8卷 / 10期

关键词：

CANCER OUTCOMES; DISPARITIES;

D O I：

10.1182/bloodadvances.2023011996

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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.

引用

页码：2592 / 2599

页数：8

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