Accessing Specialized Care Centers Can Help Reduce Health Disparities for People with Multiple Myeloma

New research shows that equitable access to specialty care may help overcome existing health disparities for patients with relapsed/refractory multiple myeloma receiving T-cell engagers. The data was shared at the American Society of Clinical Oncology (ASCO)  Annual Meeting in June.

Dr. Lindsay Fogel presented how race, income, insurance, and language affect treatment outcomes for people with relapsed/refractory myeloma who are receiving T-cell engagers. In this article, you’ll learn insights on how equitable access to specialty care may help overcome existing health disparities.

Understanding T-cell Engagers in Relapsed Myeloma

T-cell engagers (TCEs) help the immune system recognize and eliminate myeloma cells. Currently, there are three FDA-approved TCEs: teclistamab (Tecvayli), talquetamab (Talvey), and elranatamab (Elrexfio). These therapies are effective for relapsed/refractory multiple myeloma patients who have received several previous therapies.

The response rates to TCEs reach 60% to 70%, and progression-free survival can range from 10 to 22 months. However, to access these therapies, patients often need treatment in specialized centers to manage side effects like cytokine release syndrome (CRS) or immune-related brain effects such as ICANS.

Understanding T-cell Engagers in Relapsed Myeloma

T-cell engagers (TCEs) help the immune system recognize and eliminate myeloma cells. Currently, there are three FDA-approved treatments: teclistamab (Tecvayli), talquetamab (Talvey), and elranatamab (Elrexfio). These therapies are effective for relapsed/refractory multiple myeloma patients who have received several previous therapies.

In clinical practice, response rates to TCEs reach 60–70%, and progression-free survival can range from 10 to 22 months. However, access to these therapies often requires treatment in specialized centers due to safety protocols for managing side effects like cytokine release syndrome (CRS) or immune-related brain effects such as ICANS.

Do Sociodemographic Factors Affect Outcomes?

Health disparities refer to differences in how people experience the burden of disease, injury, violence, or opportunities to access health. These disparities are linked to socioeconomic and/or environmental disadvantages.

Previous studies have shown that Black, Hispanic, and lower-income patients with myeloma often experience worse outcomes. This study aimed to evaluate whether those same factors affected outcomes for patients receiving T-cell engagers.

Researchers conducted a retrospective study (which analyzed past events) at a single myeloma center, analyzing medical records of 79 patients who were treated between January 2023 and October 2024. They examined factors such as race, income, insurance type, and primary language to see if they were linked to treatment results like overall response rate (ORR), progression-free survival (PFS), or overall survival (OS).

Patient Characteristics 

• 40% of patients were people of color, including 18% Black and 18% Hispanic individuals. 
• 22% of patients were non-English speakers.
• The average income was $106,110, and about 35% had public insurance through Medicare or Medicaid.
• Over 60% of patients had high-risk genetic features, and nearly half had been treated with BCMA-targeted therapies before. 
• All patients had been treated with the three major classes of myeloma therapies, and 70% had received five or more prior medications.

Study Results

The main takeaway was that race, income level, and insurance status did not impact treatment outcomes in this study. This means that the treatment endpoints were similar for all patients, regardless of background.

All patients in this study received care at a dedicated myeloma center with support services such as multilingual translators and experienced care teams. This environment reduced the impact of socioeconomic and racial disparities that are usually seen in broader populations. 

Equitable access to specialty care may help close the gap in myeloma outcomes. When patients are treated in systems that reduce financial and communication barriers, new treatments can be effective across diverse groups.

Key Takeaways

These findings show that for myeloma patients who have tried several therapies, receiving care in a specialized myeloma center can help ensure equal access to the benefits of newer treatments like T-cell engagers. These results support the importance of expanding access to expert care centers to improve outcomes for all patients.

Future studies will compare outcomes between community and specialty centers to understand how to best reduce health disparities in myeloma treatment.

Read more about disparities in healthcare in these articles: 

• Closing the Gaps in Multiple Myeloma Care for African Americans
• Addressing Disparities in Myeloma Care: New HealthTree University Unit Now Available
• Evaluating Racial Influence on Machine Learning Predictive Models

Source: 

• Impact of racial disparities on efficacy and safety outcomes for patients with RRMM receiving T-cell engagers.