ASH 2025 | Real-world barriers to treatment access in T-cell lymphoma

In this abstract, we attempted to identify real-world barriers to treatment access among T-cell lymphoma patients. So in general, T-cell lymphoma is associated with limited therapeutic options and poor outcomes, and therefore identifying real-world barriers to treatment is essential to inform strategies that will optimize care delivery and improve outcomes in this underserved population. Therefore, we conducted a retrospective study of patients with a primary diagnosis of T-cell lymphoma who were seen at the Fred Hutch Cancer Center and did statistical analysis to observe treatment trends. 

So between 2014 and 2024, 400 patients were identified. 89% of patients had insurance coverage: 32% were enrolled in commercial PPO plans, 29% in Medicare, 15% in Medicaid, and 7.8% in commercial HMO plans. 11% of patients were uninsured. 56% of patients received at least one novel agent during their treatment, while 27% received only conventional chemotherapy. 7% only participated in at least one clinical trial. Among patients who had CD30-positive disease, 36% were treated with a brentuximab-containing regimen. Treatment patterns varied significantly by T-cell lymphoma subtypes with patients with anaplastic large-cell lymphoma and nodal T-follicular helper lymphoma who were most likely to receive at least one novel or experimental agent. And in contrast, those with LGL and CTCL more often received therapies outside of conventional chemotherapy or novel agent-based regimens. Among patients who had CD30-positive disease, Brentuximab was significantly associated with insurance status, with only 4.8% of uninsured patients receiving brentuximab compared to 41% of insured patients. Clinical trial participation also varied significantly by both insurance status and T-cell lymphoma subtype, with 7.8% of insured patients enrolled in at least one clinical trial, whereas no uninsured patients participated in clinical trials. 

So overall, to conclude, real-world treatment patterns in T-cell lymphoma vary significantly by histologic subtype and insurance status, with notable disparities in access to novel therapies, brentuximab, and clinical participation. And these findings essentially highlight the need for targeted efforts to address structural barriers in care delivery and ensure equitable access for this patient population.

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