Addressing Disparities in CAR-T Access in Treating Multiple Myeloma
Key Clinical Takeaways
- Population and Focus: At the 2025 LL&M Congress (New York, NY), Joshua Richter, MD, Tisch Cancer Institute, reviewed the long-term efficacy and equity challenges of CAR T-cell therapy for MM.
- Findings: CARTITUDE-1 five-year data show that approximately one-third of heavily pretreated patients remain in complete remission, suggesting potential functional cures. However, access remains limited to major academic centers, excluding many patients in community settings, lower socioeconomic groups, and racial/ethnic minorities.
- Clinical Relevance: Efforts are underway to expand CAR T delivery beyond tertiary centers through community partnerships and training, ensuring equitable access and enabling broader implementation of curative myeloma therapies.
Joshua Richter, MD, Tisch Cancer Institute, New York, New York, discussed the transformative potential of CAR T-cell therapy for multiple myeloma (MM) treatment, highlighting long-term data from CARTITUDE-1 show durable remissions and possible cures for a subset of heavily pretreated patients at the 2025 Lymphoma, Leukemia & Myeloma (LL&M) Congress in New York, New York.
He highlighted the urgent need to expand access beyond academic centers, addressing disparities affecting patients in community settings, lower socioeconomic groups, and racial and ethnic minorities.
Transcript:
Hi, my name is Dr. Joshua Richter. I'm an associate professor of medicine at the Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai and the director of Myeloma at the Blavatnik Family, Chelsea Medical Center at Mount Sinai. I'm excited to be here at LL&M 2025 to talk about CAR-Ts and bridging the gap, and making sure that everyone has access to this wonderful technology.
I was lucky enough to share the stage with Adam Cohen, who walked us through some of the amazing advantages that CAR T therapy has brought with us to the world of myeloma. In fact, if we look now even at the original CARTITUDE-1 data, we see that 5 years later, a third of people who had no other options, remain in complete remission, off of therapy, and may in fact be cured.
This is absolutely amazing, but the reality is this is a therapy that's only available for a small number of patients at the moment. We recognize in the United States that 80% of myeloma is treated in the community, and that many people, either of lower socioeconomic status or a variety of different ethnic subgroups, including non-white Hispanics and black and African American patients, may have less access to these types of therapies. We need to make sure that we continue to develop these amazing technologies with the notion in mind that everyone, regardless of where they are, needs to have access to this amazing type of treatment.
In addition, we recognize that right now the majority of this is being administered in high-level academic centers because of the expertise and infrastructure needed to provide this. However, there are ongoing efforts to try to involve our community partners to work with them so that it doesn't have to be an all or none phenomenon. Recognizing that here in the amazing city of New York, you can take a heavy rock and hit 5 amazing CAR-T centers, but in many states in this country, patients have to drive hours and hours to have access to this type of therapy.
What this means is that not only are they not referred for it quite as often, but they may not even be eligible for it and/or if they have toxicities, they are potentially many hours from the main center and not with a care team that is familiar dealing with the post-CAR-T toxicities and management strategies.
It's the continuing effort of the myeloma community to make sure that, as we strive for a cure, it's not a cure for a small number of patients but providing the optimal therapy for everyone with myeloma, everywhere. Thank you.
Source:
Richter J. Evolving Strategies for CAR T-Cell Therapy in Relapsed/Refractory Multiple Myeloma. Presented at Lymphoma, Leukemia & Myeloma Congress; October 14-17, 2025. New York, NY.
