Presentation (CTI)

OBJECTIVES: Approvals for CAR T therapies (e.g., liscabtagene maraleucel [liso-cel]) were expanded in 2022 to the 2L setting for select patients with R/R LBCL. With the introduction of CAR T options earlier in the R/R LBCL treatment landscape, use of CAR T in the 2L, preferred treatment sequencing, and potential access barriers remain unclear.
METHODS: US oncologists at in-person forums (June 2023 [N=69], October 2024 [N=52]) were surveyed on CAR T therapy for patients with R/R LBCL. Attendance at both forums was allowed but not required. The June forum focused on liso-cel. The October 2024 forum focused on real-world evidence in LBCL. Participants were not required to answer every question. Responses were analyzed by forum using descriptive statistics.
RESULTS: In June 2023, most US oncologists were aware of the liso-cel approval in the 2L (10% unaware). After reviewing liso-cel trial data, 61% of respondents felt the results supported use of CAR T therapy in earlier lines. Physicians were open to using 2L CAR T therapy, with 46% anticipating using liso-cel for eligible 2L patients. Limited spot availability at CAR T centers was the top barrier to referring patients for CAR T therapy. In October 2024, the majority (57%) preferring CAR T in 2L, bispecific antibody therapy in 3L, and antibody-drug conjugate in 4L for LBCL patients who relapse <1 year after chemoimmunotherapy.
CONCLUSIONS: Overall, oncologists in mid-2023 were aware of CAR T therapy approvals for 2L and broadly receptive to CAR T therapy in an earlier treatment setting. In late 2024, most physicians preferred using CAR T in 2L. Limited capacity at CAR T centers remain a barrier to referring patients with R/R LBCL, suggesting a need for expanded CAR T infrastructure.