Access to CAR T-Cell Therapies in Minority Communities: A Patient Survey Study of Disparities in Multiple Myeloma Care

Abstract

Background

Chimeric Antigen Receptor (CAR) T-cell therapy is a groundbreaking treatment for multiple myeloma, offering a potentially life-extending option for eligible patients. However, due to its high cost, intensive logistical requirements, and availability generally limited to specialized centers, access may not be equitably distributed. Black and Hispanic patient may experience disproportionately limited access to this therapy. While institutional and systemic disparities have been documented, less is known about how patient-level experiences, perceptions, and social determinants influence access and treatment outcomes.

Objective

This study aims to characterize disparities in access to CAR T-cell therapy among patients with multiple myeloma, with a particular focus on race, ethnicity, socioeconomic status, and social determinants of health. It further seeks to assess how these factors influence patient satisfaction and perceptions around treatment decision-making.

Methods

This is a prospective, cross-sectional survey study involving patients diagnosed with multiple myeloma, including those who are eligible for or have considered CAR T-cell therapy and who are enrolled in the HealthTree research registry. Participants will complete a 25–35-minute survey consisting of up to 46 questions on treatment experiences, access to care, perceived barriers, and patient-reported outcomes. An additional 11 questions will capture demographic and socioeconomic data, including race/ethnicity, education level, insurance type, and neighborhood-level metrics. The survey will be disseminated electronically via the HealthTree platform. Data will be analyzed using descriptive statistics and comparative analyses (e.g., chi-square tests, t-tests, ANOVA), with multivariable models used to assess factors associated with disparities in access and outcomes.

Results (Trial in Progress)

As of June 2025, data collection is ongoing. Preliminary survey responses have been received from a diverse group of participants enrolled in the HealthTree registry.

Discussion

This study will provide real-world patient-level insights into disparities in CAR T-cell therapy access, beyond clinical and institutional metrics. By highlighting patient experiences and perceptions, it aims to inform policy, provider education, and system-level interventions that can close the access gap and improve equity in advanced myeloma care.