CT-403: Adoption of Approved CAR-T Therapies Among U.S. Community Hematologists/Oncologists

Abstract

Context Several chimeric antigen receptor T-cell (CAR-T) therapies are approved in the U.S. for the treatment of relapsed or refractory large B-cell lymphoma (R/R LBCL). Almost half of all U.S. patients with cancer are treated in community-based oncology practices. Understanding the adoption of novel therapies by community hematologists/oncologists (cH/O) is critical to assessing their future utilization and impact on clinical outcomes. Objective To assess one-year temporal trends for CAR-T utilization among cH/O and their perceptions regarding the barriers to adoption of CAR-T therapies in R/R LBCL. Design U.S. cH/O were convened at live meetings held in February 2019 (cohort A) and Winter 2020 (cohort B). Participants were queried on their CAR-T therapy perceptions, utilization, and referral patterns. Responses were captured via a web-based survey and live polling during the meetings. Results Cohorts A and B comprised 59 and 168 participants, respectively; 61% and 71% identified their primary specialty as hematology/oncology; 94% and 90% practice in a community setting; both cohorts see an average of 20+ patients per day on clinic days. Significantly more participants in Cohort B had referred patients for CAR-T in the preceding 6 months (54% vs 93%, p Conclusion CAR-T referrals increased, but the rate of therapy infusion was unchanged. Cost and toxicity remain significant barriers to utilization. Support from manufacturers, payers, and CAR-T centers is vital to facilitate timely access to therapy for patients.