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Access to Chimeric Antigen Receptor T Cell Therapy for Diffuse Large B Cell Lymphoma
INTRODUCTION: Geographic access to novel oncology therapies, and the extent to which it may vary by potential sites of care, regions, and population characteristics, is poorly understood. We examined how expanding access to chimeric antigen receptor (CAR) T cell therapy administration sites impacts...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Healthcare
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8408091/ https://www.ncbi.nlm.nih.gov/pubmed/34302277 http://dx.doi.org/10.1007/s12325-021-01838-z |
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author | Snyder, Sophie Chung, Karen C. Jun, Monika P. Gitlin, Matthew |
author_facet | Snyder, Sophie Chung, Karen C. Jun, Monika P. Gitlin, Matthew |
author_sort | Snyder, Sophie |
collection | PubMed |
description | INTRODUCTION: Geographic access to novel oncology therapies, and the extent to which it may vary by potential sites of care, regions, and population characteristics, is poorly understood. We examined how expanding access to chimeric antigen receptor (CAR) T cell therapy administration sites impacts patient travel distances and time. METHODS: We used geographic information system techniques to calculate shortest travel distance and time between patients with relapsed/refractory diffuse large B cell lymphoma (DLBCL) and the nearest CAR T cell therapy administration site in three scenarios: academic hospitals; academic and community multispecialty hospitals; and academic and community multispecialty hospitals plus nonacademic specialty oncology network centers. Main outcome measures were differences in travel distance and time among the scenarios and the relationship between travel time and socioeconomic status, race, rural–urban areas, and non-Hodgkin lymphoma clusters. Non-Hodgkin lymphoma incidence, socioeconomic status, and administration centers were derived from governmental/publicly available data sources. RESULTS: Of 3922 patients eligible for CAR T cell therapy, more than 37% had to travel more than 1 h to the nearest academic hospital. Average travel time and distance were significantly reduced by 23% and 30% (P < 0.001), respectively, when access was expanded to include community hospitals plus a broader range of oncology specialty treatment centers. Compared to academic hospitals alone, increasing access to include community hospitals decreased time and distance by 7% and 8% (P < 0.01), respectively. In addition, there would be a lower proportion of sites operating as the only care provider within 25 miles if access was expanded outside of academic hospitals only. Longer travel time was associated with lower socioeconomic status. CONCLUSION: Many patients with DLBCL have long travel times to an academic hospital that administers CAR T cell therapy. Expanding access to care through site-of-care planning will help address regional, rural–urban, and sociodemographic equity in the geographic allocation of CAR T cell therapy. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12325-021-01838-z. |
format | Online Article Text |
id | pubmed-8408091 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer Healthcare |
record_format | MEDLINE/PubMed |
spelling | pubmed-84080912021-09-09 Access to Chimeric Antigen Receptor T Cell Therapy for Diffuse Large B Cell Lymphoma Snyder, Sophie Chung, Karen C. Jun, Monika P. Gitlin, Matthew Adv Ther Original Research INTRODUCTION: Geographic access to novel oncology therapies, and the extent to which it may vary by potential sites of care, regions, and population characteristics, is poorly understood. We examined how expanding access to chimeric antigen receptor (CAR) T cell therapy administration sites impacts patient travel distances and time. METHODS: We used geographic information system techniques to calculate shortest travel distance and time between patients with relapsed/refractory diffuse large B cell lymphoma (DLBCL) and the nearest CAR T cell therapy administration site in three scenarios: academic hospitals; academic and community multispecialty hospitals; and academic and community multispecialty hospitals plus nonacademic specialty oncology network centers. Main outcome measures were differences in travel distance and time among the scenarios and the relationship between travel time and socioeconomic status, race, rural–urban areas, and non-Hodgkin lymphoma clusters. Non-Hodgkin lymphoma incidence, socioeconomic status, and administration centers were derived from governmental/publicly available data sources. RESULTS: Of 3922 patients eligible for CAR T cell therapy, more than 37% had to travel more than 1 h to the nearest academic hospital. Average travel time and distance were significantly reduced by 23% and 30% (P < 0.001), respectively, when access was expanded to include community hospitals plus a broader range of oncology specialty treatment centers. Compared to academic hospitals alone, increasing access to include community hospitals decreased time and distance by 7% and 8% (P < 0.01), respectively. In addition, there would be a lower proportion of sites operating as the only care provider within 25 miles if access was expanded outside of academic hospitals only. Longer travel time was associated with lower socioeconomic status. CONCLUSION: Many patients with DLBCL have long travel times to an academic hospital that administers CAR T cell therapy. Expanding access to care through site-of-care planning will help address regional, rural–urban, and sociodemographic equity in the geographic allocation of CAR T cell therapy. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12325-021-01838-z. Springer Healthcare 2021-07-23 2021 /pmc/articles/PMC8408091/ /pubmed/34302277 http://dx.doi.org/10.1007/s12325-021-01838-z Text en © The Author(s) 2021 https://creativecommons.org/licenses/by-nc/4.0/Open AccessThis article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | Original Research Snyder, Sophie Chung, Karen C. Jun, Monika P. Gitlin, Matthew Access to Chimeric Antigen Receptor T Cell Therapy for Diffuse Large B Cell Lymphoma |
title | Access to Chimeric Antigen Receptor T Cell Therapy for Diffuse Large B Cell Lymphoma |
title_full | Access to Chimeric Antigen Receptor T Cell Therapy for Diffuse Large B Cell Lymphoma |
title_fullStr | Access to Chimeric Antigen Receptor T Cell Therapy for Diffuse Large B Cell Lymphoma |
title_full_unstemmed | Access to Chimeric Antigen Receptor T Cell Therapy for Diffuse Large B Cell Lymphoma |
title_short | Access to Chimeric Antigen Receptor T Cell Therapy for Diffuse Large B Cell Lymphoma |
title_sort | access to chimeric antigen receptor t cell therapy for diffuse large b cell lymphoma |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8408091/ https://www.ncbi.nlm.nih.gov/pubmed/34302277 http://dx.doi.org/10.1007/s12325-021-01838-z |
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