"You Have Your Knowledge, but I Have My Knowledge of My Body": The Hematologist-Patient Relationship and Enrollment of Black Participants in Clinical Trials

Grant, Shakira J.; Jean-Baptiste, Milenka; Moore, Mykela; Mills, Jiona; Bates, Lauren; Tuchman, Sascha A.; Mihas, Paul

doi:10.1182/blood-2022-170394

Cited by 2 publications

(1 citation statement)

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“…86 Although geographic location as a measure of availability is critical, Black persons with MM encounter several multilevel barriers such as clinician bias and stereotyping that influence the decision to offer trials to certain groups and perceived untrustworthiness and general distrust of the health care system and research enterprise, especially among the Black population. 87-89 As mentioned above, a study of real-world patients, including those with MM, demonstrated that those who self-identified as Black race were less likely to receive CAR T-cell therapy. 78 Gormley et al 90 have suggested concrete steps to eliminating racial disparities in outcomes in MM.…”

Section: Access To Care and Equity In Real-world Settingsmentioning

confidence: 98%

Chimeric Antigen Receptor T-Cell and Bispecific Antibody Therapy in Multiple Myeloma: Moving Into the Future

Holstein

Grant

Wildes

2023

JCO

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Historically, the outcomes for individuals with triple-class refractory and penta-drug refractory multiple myeloma (MM) have been poor because of a dearth of effective treatment options. However, the advent of chimeric antigen receptor (CAR) T-cell and T-cell redirecting bispecific antibody (BsAb) therapies has led to unprecedented response rates and durations of response in heavily relapsed/refractory (R/R) populations. Currently, two B-cell maturation antigen (BCMA)–directed CAR T-cell therapies (idecabtagene vicleucel and ciltacabtagene autoleucel) as well as one BCMA/CD3 BsAb (teclistamab) have been approved for late-line (greater than four previous lines) R/R MM in the United States. The purpose of this review is to analyze the recent data for these approved therapies as well as provide an overview of other related CAR T-cell and BsAb therapies under development, including non–BCMA-targeting agents. We review efficacy and safety considerations, with particular focus on cytokine release syndrome, neurotoxicity, and infection risk. The relative merits and limitations of each class of therapy are discussed, as well as the areas of unmet need with respect to optimal sequencing and supportive care measures. We examine the factors that challenge equitable access to these novel therapies across minoritized racial, ethnic, and socioeconomic populations. Although it is evident that CAR T-cell and BsAb therapies will transform treatment paradigms in MM for years to come, significant work remains to identify the optimal utilization of these novel therapies and ensure equitable access.

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