11189 Background: Real-world data consistently demonstrates that access to novel myeloma therapies (CAR-T and Bispecific Antibodies BsAb) is restricted by "classic" disparities, including lower income, rural geography, and distance from academic medical centers. However, evidence suggests that strong institutional support and patient navigation can mitigate these factors. While direct-to-patient platforms remain underexplored, high digital engagement—driven by education and medical data ownership—are hypothesized to mitigate traditional barriers. To evaluate this, the HealthTree Registry was queried to determine if its engaged cohort exhibits the disparities observed in the general population. Methods: A total of 1, 519 Multiple Myeloma patients, diagnosed after 2014, and who connected their Electronic Health Records (EHR) and provided survey data within the HealthTree, were originally extracted. Line of treatment data was extracted from clinical plan and progress notes. Eligibility for novel therapies was retrospectively determined based on FDA approval criteria (lines of therapy and dates). Utilization rates comparisons against demographic variables using Chi-square and ANOVA tests. Results: Among the cohort, 277 patients were eligible for CAR-T and 91 for BsAbs. Contrary to general population trends, digital engagement appeared to neutralize classic socioeconomic barriers. We found no significant difference in novel therapy utilization based on median zipcode income (Users: 103k vs. Non-Users: 95k, p = 0. 88), distance to clinic (p = 0. 64), or rural/urban status (p = 0. 808). Utilization rates: 30% (84/277) of eligible patients received CAR-T compared to 54% (49/91) for BsAbs. Patients receiving novel therapies had a mean age of 65. 9 years and initiated treatment 3. 7 years after diagnosis. BsAbs were utilized later in the disease course (Mean Line of Therapy LOTs: 6. 0) compared to CAR-T (Mean Line of Therapy: 4. 8), due to FDA eligibility criteria restrictions. CAR-T utilization was high during early LOTs (2-4) at 48%. While economic and geographic barriers were mitigated, a significant gender disparity emerged in continuous therapy usage. For BsAbs, 66% (33/50) of eligible men received therapy, compared to only 39% (16/41) of eligible women (p = 0. 018). No gender difference was observed for CAR-T (p = 1. 0). Conclusions: In this cohort, although a greater proportion of patients met eligibility criteria for CAR-T than for BsAb, eligible patients were more likely to initiate BsAb treatment. However, digital engagement of patients facilitated early use of CAR-T therapy and reduced traditional barriers like distance and income, which may be less limiting than previously thought. In contrast, a pronounced gender disparity in BsAb therapy utilization suggests that continuous therapies may impose a disproportionate logistical burden on eligible female patients.
Hydren et al. (Wed,) studied this question.