获得CAR T细胞治疗:关注多样性、公平性和包容性。

IF 6.9 2区 医学 Q1 HEMATOLOGY Blood Reviews Pub Date : 2024-01-01 DOI:10.1016/j.blre.2023.101136
Maria S. Odstrcil , Catherine J. Lee , Catherine Sobieski , Daniel Weisdorf , Daniel Couriel
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引用次数: 0

摘要

嵌合抗原受体T细胞(CAR T细胞)治疗在没有其他治疗选择的复发或难治性疾病患者中彻底改变了血液系统恶性肿瘤的治疗。然而,只有极少数具有CAR T细胞适应症的患者可以接受治疗。供应和需求之间的不平衡在少数群体和弱势群体中被放大。有限的获取是多因素的,部分原因是与细胞产品直接相关的因素,如成本、复杂的物流和制造限制。另一方面,多样性、公平性和包容性(DEI)的影响及其社会和结构背景也是理解细胞治疗和医疗保健中普遍存在的获取障碍的关键。CAR T细胞疗法为我们提供了一个新的机会,让我们更好地理解并优先考虑这一差距,这是积极和战略性地解决获取问题的关键一步。本综述的目的是分析CAR T治疗的现状,重点关注DEI的影响。我们将涵盖与细胞产物相关的方面,以及社会和结构决定因素的不可分割的背景。识别和解决障碍对于确保公平获得这一疗法以及未来所有新疗法是必要的。
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Access to CAR T-cell therapy: Focus on diversity, equity and inclusion

Chimeric antigen receptor T-cell (CAR T-cell) therapy has revolutionized the treatment of hematologic malignancies in patients with relapsed or refractory disease without other treatment options. However, only a very small proportion of patients with an indication for CAR T-cell can access the treatment. The imbalance between supply and demand is magnified in minority and vulnerable populations. Limited access is multifactorial and in part a result of factors directly related to the cellular product such as cost, complex logistics and manufacturing limitations. On the other hand, the impact of diversity, equity, and inclusion (DEI) and their social and structural context are also key to understanding access barriers in cellular therapy and health care in general. CAR T-cell therapy provides us with a new opportunity to better understand and prioritize this gap, a key step towards proactively and strategically addressing access.

The aim of this review is to provide an analysis of the current state of access to CAR T therapy with a focus on the influence of DEI. We will cover aspects related to the cellular product and the inseparable context of social and structural determinants. Identifying and addressing barriers is necessary to ensure equitable access to this and all future novel therapies.

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来源期刊
Blood Reviews
Blood Reviews 医学-血液学
CiteScore
13.80
自引率
1.40%
发文量
78
期刊介绍: Blood Reviews, a highly regarded international journal, serves as a vital information hub, offering comprehensive evaluations of clinical practices and research insights from esteemed experts. Specially commissioned, peer-reviewed articles authored by leading researchers and practitioners ensure extensive global coverage across all sub-specialties of hematology.
期刊最新文献
From MGUS to multiple myeloma: Unraveling the unknown of precursor states. Advancing CAR T-cell therapies: Preclinical insights and clinical translation for hematological malignancies. Corrigendum to "Measurable residual disease (MRD)-testing in haematological cancers: A giant leap forward or sideways?"[BLOOD REVIEWS, 9 August 2024, https://doi.org/10.1016/j.blre.2024.101226]. Clinical applications of circulating tumor DNA in hematological malignancies: From past to the future Tailoring oral anticoagulant treatment in the era of multi-drug therapies for PAH and CTEPH.
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