Public health professionals have a keen desire to know if there are any obstacles in bringing treatment to certain segments of the population. For example, they want to know if there are health outcome differences for men and women using the same medication or other type of treatment modality, or if age plays a pivotal factor.
When it comes to CAR-T therapy, the clinical trials that scientists conducted before the Food and Drug Administration approved this form of treatment did not include very many Black or Hispanic individuals.
About CAR-T Therapy
How does CAR-T therapy work? The term comes from the phrase, “chimeric antigen receptor-based therapy.” A technician obtains a sample from the patient’s blood and then extracts T cells from this blood. T cells are a component of the human immune system. Then, they alter the T cells to create chimeric antigen receptors on their surface.
At this point, a medical professional injects the chimeric antigen receptor T cells into the patient’s body. The receptors are meant to help the immune system find cancer cells and destroy them.
Findings About Black and Hispanic Patients Using CAR-T
Regarding the lack of Hispanic and Black patients undergoing clinical trials for CAR-T prior to FDA approval of this new therapy, researchers at the National Cancer Institute-designated Montefiore Einstein Cancer Center published a study this April in the scientific journal Blood Marrow Transplantation (BMT).
Their report indicates that “Black and Hispanic patients had outcomes and side effects following CAR-T treatment that were comparable to their white and Asian counterparts,” per Yahoo Finance.
What’s at issue is the fact that people of Black and Hispanic backgrounds frequently have immune system biology and tumor biology that’s quite different from white patients. What’s more, they also often experience different side effects from treatments. Since not very many minority patients wound up being entered into CAR-T trials, there were concerns in the medical community about what the effects might be on these demographics needing cancer treatment.
Mendel Goldfinger, M.D., a co-author of the BMT paper, noted that it’s crucial for cancer treatments to be shown as effective and safe for all people. He related that his staff was happy to learn that Black and Hispanic patients are getting the same level of benefits with CAR-T treatments as white patients.
The BMT study examined the histories of 46 patients whom doctors treated at Montefiore Einstein Cancer Center. The group broke down into racial groups as follows:
* Hispanic: 17
* White: 15
* Black: 9
* Asian: 5
The study showed that 58% of Black and Hispanic patients experienced a complete response to the treatment, while 19% had a partial response. It also noted that 70% of white patients and Asian patients (grouped together for statistical purposes here) achieved a complete response and 20% of them had a partial response.
Side effects were approximately the same across the board for all races under study. About 95% of the patients were diagnosed with moderate cytokine release syndrome, which often is a side effect that occurs in immunotherapy sessions. The reaction is akin to having a fever and symptoms of influenza.
Ensuring That Minority Patients Figure Into Future Clinical Medical Trials
It seems that given the promise of CAR-T therapy to treat people when other therapies have not succeeded, we should test such treatments on as wide a range of people as possible. There’s no need to cause certain members of the population to feel dismissed or cut out of the research opportunities that others can avail themselves of.
Perhaps the news out of Montefiore Einstein Cancer Center about Hispanic and Black patient parity in CAR-T treatments will help to underscore the importance of broad testing in the population for new potential therapies going forward.
