Addressing Financial, Psychosocial Barriers to CAR T-Cell Access for LBCL

It is crucial to provide travel support and housing support to increase access to CAR T-cell therapy for patients with large B-cell lymphoma who have various psychosocial and financial challenges, according to David L. Porter, MD.

Porter, the director of Cell Therapy and Transplant at the University of Pennsylvania School of Medicine, spoke with CancerNetwork during the 2024 Transplantation and Cellular Therapy Meetings about findings from a community oncologist roundtable that convened to address various barriers to CAR T-cell consultation for patients with LBCL.

He highlighted the burdens associated with long-distance travelling and finding a caregiver among patients with LBCL who seek access to treatment with CAR T-cell therapy. According to Porter, developments in the field may be necessary so that providers can bring this treatment to patients rather than having them travel to a treatment center where it’s exclusively available.

Transcript:

The group acknowledged that psychosocial and financial challenges are a major barrier to access of CAR T cells. Right now, CAR T-cell therapy is generally limited to largely the academic medical centers, the larger medical centers with experience and expertise in doing cell therapies. Typically, they are Foundation for the Accreditation of Cellular Therapy [FACT]–accredited. It is not a therapy that is easily accessible in the community. For many people who live far away from these treatment centers, the centers of excellence, [accessing treatment] requires travel. It requires perhaps great distance travel for an initial evaluation. Then, during an episode of care, patients are required to stay close to the treatment center generally for about a month. That’s an enormous burden for someone who lives far away. It requires them to [pack] up their entire life, in some cases, to move, and they are required to have a caregiver. It’s not just the patient having to [pack] up their entire life and move to be near the treatment center; they have to have somebody to go with them. We recognize that’s a major burden. We recognize that limits access in many cases.

In some instances, that may not be easily addressable other than [the fact that] we must be able to provide support for people. There must be financial support, travel support, and housing support. But I also believe in the future that the field needs to move in a direction where we can bring this therapy to where patients are and not only have a therapy where patients must come to the treatment center. There’s a lot of work and a lot of interest in trying to do that. But that’s still a little way off.

Reference

Riedell PA, Downs C, Boehmer L, Ebmeier J, Porter D, Williams A. If They RECUR, you should refer: a community oncologist patient ID roundtable summary. Transplantation and Cellular Therapy. 2024;30(1):14-16. doi:10.1016/j.jtct.2023.10.019