Expanding Access to CAR T, Bispecific Therapies Requires System Changes: Peter Forsberg, MD

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Chimeric antigen receptor (CAR) T-cell therapies and bispecific antibodies are moving into earlier lines of treatment for patients who have multiple myeloma, but health systems still need to adapt to ensure patients’ access remains without care delays or fragmentation. As these therapies move into earlier lines, it significantly expands the number of patients eligible to receive them, Peter Forsberg, MD, a hematologist-oncologist at Colorado Blood Cancer Institute and panelist at the Denver regional Institute for Value-Based Medicine^®, said in an interview with The American Journal of Managed Care^®.

“As the trials that lead to these approvals demonstrate really dramatic improvements in efficacy, it's really a necessity that we find improved ways to get access to these treatments to more patients,” he said.

Forsberg emphasized that health systems haven’t been fully operationalized to deliver these treatments on such a scale, and clinicians are working to find ways to expand access to treatments such as CAR T-cell therapy and bispecific T-cell engagers, for example.

“But where there is still a need for engagement for building structures and approaches to managing new toxicities, such as cytokine release syndrome, which is just outside of the new toxicities, there is a classical scope for a lot of systems,” Forsberg said. “It's a work in progress, but it is one that I think everybody understands the necessity of.”

However, there is no “one-size-fits-all” strategy to help health institutions implement or broaden access to these therapies, he emphasized. Each health institution has its own system and may require different measures across higher-level engagement, involving stakeholders and even community oncologists at the clinic level.

“I do think with how effective our new immunotherapeutic options in particular are, thinking about what system-level improvements need to be made to allow equity, and sustainability is key because I do think that the deep work that might require it has sometimes been lacking,” Forsberg said.