Dr Ruella on the Importance of Clinical Trial and Treatment Accessibility for Myeloma

"Therapy that cannot be done in a tertiary center is not going to be equitable and accessible to everyone, and so we need to develop these therapies in a way that can potentially be implemented in the community."

Marco Ruella, MD, an assistant professor of medicine (hematology-oncology) in the Department of Medicine in the Division of Hematology/Oncology and the Center for Cellular Immunotherapies at the University of Pennsylvania Perelman School of Medicine; as well as the scientific director of the Lymphoma Program at the Hospital of the University of Pennsylvania, discusses the importance of developing cancer treatments, including CAR T-cell therapy, that are accessible to diverse populations of patients with multiple myeloma.

Conferences like the ASH Annual Meeting often feature research investigating highly sophisticated and advanced therapies, Ruella begins. However, if these treatments cannot be delivered equitably to patients, the extent of their real-world benefit remains unknown, he says. Therefore, considering accessibility is crucial when designing clinical trials and determining the commercial application of these therapies, he explains. 

Treatments that can only be administered in tertiary centers will not be universally accessible to patients, limiting their reach, Ruella notes. Accordingly, it is essential for drug developers to consider the feasibility of incorporatingthese agents into community practices in the future, he emphasizes. These considerations should be accounted for early in the drug development process to promote equitable health care access, he notes. 

At the 2024 ASH Annual Meeting, Ruella and colleagues presented findings from an analysis of treatment access and outcomes in minority health populations receiving commercial BCMA-directed CAR T-cell therapy for multiple myeloma. This research showed that patients in minority health populations have equitable access to tertiary care for multiple myeloma when compared with those in non-minority health populations but have reduced access to commercial anti-BCMA CAR T-cell therapy.