Access to CAR-T Therapy for HIV-Positive Cancer Patients
For individuals living with HIV, obtaining promising cancer treatments, such as chimeric antigen receptor T-cell (CAR-T) therapy, may involve significantly longer travel times compared to those without HIV. A recent multi-institutional study revealed that HIV-positive cancer patients encounter notable barriers related to geographic access to CAR-T clinical trials.
Study Overview
Researchers from various institutions, including the University of Notre Dame’s Civic-Geospatial Analysis and Learning Lab, collaborated to analyze the accessibility of CAR-T therapy trials for patients living with HIV. CAR-T therapy has been transformative for treating relapsed or refractory non-Hodgkin lymphoma (NHL) and offers hope for those with HIV, who face higher cancer mortality rates.
Key Findings
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Travel Time Disparities: The study found that HIV-positive individuals experienced a median travel time of 1.15 hours to the nearest CAR-T clinical trial, compared to 0.84 hours for those without HIV. In regions with higher HIV prevalence, such as the U.S. South, the gap widened to 1.70 hours versus 0.92 hours.
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Exclusion from Trials: Only 13.8% of CAR-T trials included patients living with HIV, while 72.5% explicitly excluded them.
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Equity Challenges: Access to trials was also unequal across various racial and ethnic groups, income levels, and geographic areas, with lower household income linked to longer travel distances.
Recommendations
The researchers emphasized the need for:
- Expanded Eligibility: Increasing the inclusion of HIV-positive patients in clinical trials.
- Decentralized Trial Sites: Establishing more trial sites closer to underrepresented communities.
Conclusion
These findings underscore a significant gap in access to CAR-T cellular therapies for HIV-positive individuals, spotlighting the importance of geographical and racial equity in healthcare. Enhancing trial participation and accessibility could help bridge this gap.
For more information on the geospatial research conducted by the Civic-Geospatial Analysis and Learning Lab, visit the Lucy Family Institute for Data & Society website.
