START-CART: Study on Timing and Referral Trends for CAR-T Therapy: Examining Racialized Trends in the Timing of CAR-T Therapy Initiation in Multiple Myeloma

Background

CAR-T cell therapy offers transformative outcomes for patients with relapsed/refractory multiple myeloma. However, equitable access to this advanced treatment remains a critical challenge. Black patients are disproportionately affected by multiple myeloma yet remain underrepresented among those receiving novel therapies. Delays in CAR-T referral may reflect systemic inequities contributing to disparities in treatment outcomes.

Objective

To evaluate the timing and treatment burden preceding CAR-T referral among patients with multiple myeloma, with a specific focus on identifying racial disparities in referral patterns.

Methods

This retrospective chart review includes adult patients diagnosed with multiple myeloma and evaluated for CAR-T therapy at Moffitt Cancer Center between January 2022 and December 2023. Variables collected include demographic characteristics (age, sex, race), myeloma subtype, date of diagnosis, date of referral, CAR-T readiness status, and the number of treatment lines received prior to referral or evaluation. Descriptive statistics and comparative analyses will be used to assess differences across racial and demographic groups. Multivariable regression models will be employed to adjust for potential confounders such as age, disease subtype, and comorbidities.

Preliminary Status

Data collection is ongoing. Initial analyses are focused on characterizing the cohort and quantifying the average number of therapy lines received before CAR-T referral. Early trends are being explored across key categories, including race, age, and myeloma subtype, though no statistically significant findings have yet been observed.

Conclusion

This study aims to clarify whether racial disparities exist in the timing and treatment burden associated with CAR-T referral in multiple myeloma. Findings will inform future interventions to promote earlier and more equitable access to novel therapies among historically underserved populations.