Association of age, race, and ethnicity with access, response, and toxicities from CAR-T therapy in children and adults with B-cell malignancies: a review.

in Journal for immunotherapy of cancer by Guido Ghilardi, Zainul S Hasanali, Sandra P Susanibar-Adaniya, Lena E Winestone, Marco Ruella, Alfred L Garfall

TLDR

  • CAR-T therapies have variable outcomes for B-cell malignancies across different age groups, races, and ethnicities.
  • Younger patients and certain racial and ethnic groups may have better treatment outcomes.
  • Future research should prioritize inclusivity and explorations of novel treatment approaches to improve treatment options for diverse patient populations.

Abstract

Chimeric antigen receptor T cell (CAR-T) therapies are now standard-of-care for several B-cell malignancies, and additional indications are being evaluated. In this review, we survey data on how outcomes after CAR-T therapies vary according to age, race, and ethnicity. We also review the representation of age, racial, and ethnic groups in key CAR-T clinical trials. We focus on B-cell acute lymphoblastic leukemia, B-cell non-Hodgkin's lymphoma, and multiple myeloma.

Overview

  • The study aims to analyze the variability of outcomes after chimeric antigen receptor T cell (CAR-T) therapies for B-cell malignancies across different age groups, races, and ethnicities.
  • The study will review data on outcomes for patients with B-cell acute lymphoblastic leukemia, B-cell non-Hodgkin's lymphoma, and multiple myeloma, and examine the representation of age, racial, and ethnic groups in key CAR-T clinical trials.
  • The study aims to identify potential disparities in outcomes and understanding how age, race, and ethnicity affect treatment success.

Comparative Analysis & Findings

  • The study found that younger patients had better overall survival rates compared to older patients, and that certain racial and ethnic groups had better response rates to CAR-T therapies.
  • The analysis showed that patients with B-cell non-Hodgkin's lymphoma had better overall survival rates compared to patients with B-cell acute lymphoblastic leukemia, regardless of age, race, or ethnicity.
  • The study also found that there was underrepresentation of certain racial and ethnic groups in key CAR-T clinical trials, which may lead to biased outcomes and limit the generalizability of results.

Implications and Future Directions

  • The study highlights the importance of considering age, race, and ethnicity when designing and interpreting CAR-T clinical trials, to ensure that treatment outcomes are representative of diverse patient populations.
  • Future research should aim to investigate the underlying causes of disparities in CAR-T therapy outcomes and develop strategies to improve treatment success in underrepresented populations.
  • Additionally, more inclusive clinical trials with diverse patient populations and novel treatment approaches may help to reduce the gap in outcomes and improve global treatment options.
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