Abstract 888: Impact of neighborhood disadvantage, travel distance, and travel time on clinical outcomes of multiple myeloma patients treated with idecabtagene vicleucel.

Abstract Purpose: To examine the association of neighborhood disadvantage and travel distance (TD)/time (TT) with clinical outcomes in multiple myeloma (MM) patients treated with the first chimeric antigen receptor T-cell therapy (CAR T) for MM, idecabtagene vicleucel (ide-cel). Methods: MM patients who received ide-cel at Moffitt Cancer Center by July 2024 were included. Neighborhood disadvantage was defined using the Area Deprivation Index (ADI), Social Deprivation Index (SDI), and Social Vulnerability Index (SVI), with higher values indicating more disadvantaged neighborhoods (DN). TD/TT from patients’ residence to Moffitt were calculated via Google Directions API. Chi-squared, log-rank tests, and Kaplan-Meier curves were used to compare patient characteristics, safety, and efficacy by each index and TD/TT using the upper quartile as the cut-point. Multivariable logistic and Cox regression were used to examine the association of each index and TD/TT with ide-cel response and survival, respectively, adjusting for relevant covariates. Results: Among 173 MM patients treated with ide-cel, most were male (54%), non-Hispanic White (73%), and 60 years (75%). Median follow-up was 12.6 months (range 0.1-38.4). Median ADI was 42 (range 1-96), SDI was 38 (range 1-100), and SVI was 0.7 (range 0.1-1.0). Patients living in more vs less DN were younger (all indices, p0.05), more likely to be Black (SDI: 37% vs 10%, p0.001), had a prior autologous stem cell transplant (ADI: 80% vs 61%, p=0.02), and extramedullary disease (ADI: 32% vs 14%, p=0.01). Patients with higher SVI were more likely to develop infections (44% vs 25%, p=0.02) and less likely to achieve a complete response (CR) or better (44% vs 63%, p=0.03). Patients living in more vs less DN had inferior overall survival (OS; SDI: median 27 months vs not reached, p=0.04; SVI: median 18 months vs not reached, p=0.01). In multivariable models, patients living in more vs less DN were less likely to have a CR or better response (SDI: odds ratio OR=0.39, 95% confidence interval CI=0.16-0.91; SVI: OR=0.40, 95% CI=0.17-0.90) and had worse OS (SDI: hazard ratio HR=1.78, 95% CI=0.97-3.28; SVI: HR=2.14, 95% CI=1.16-3.95). No other differences in outcomes were observed by DN. Median TD and TT were 76.5 miles (range 2.5-1079.6) and 90 minutes (range 10-1022), respectively. No differences in patient characteristics or clinical outcomes by TD/TT were noted except patients with a longer TD/TT were more likely to have high-risk cytogenetics (58% vs 28%, p0.001). Patients from more DN had shorter TD/TT (all indices, p0.05). Conclusion: In MM patients treated with ide-cel, most lived in less DN yet faced significant TD/TT. The marked travel burden overall and the worse responses and inferior OS in patients living in more DN highlight the need to address systemic barriers to improve CAR T access and outcomes. Citation Format: Alicia R. Richards, Jessica Y. Islam, Yu Chen Lin, Ariel F. Grajales-Cruz, Guillermo Gonzalez-Calderon, Melanie Buhlmann, Gabe DeAvila, David Scheiber-Camoretti, Vivien Yin, Brandon Blue, Laura B. Oswald, Brandon Kale, David Kaldas, Ken Harada, Rebecca Gonzalez, Ciara L. Freeman, Hien Liu, Fabiana Perna, Taiga Nishihori, Rachid Baz, Kenneth H. Shain, Melissa Alsina, Frederick L. Locke, Omar Castaneda Puglianini, Doris K. Hansen, Lauren C. Peres. Impact of neighborhood disadvantage, travel distance, and travel time on clinical outcomes of multiple myeloma patients treated with idecabtagene vicleucel abstract. In: Proceedings of the American Association for Cancer Research Annual Meeting 2026; Part 1 (Regular Abstracts); 2026 Apr 17-22; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2026;86(7 Suppl):Abstract nr 888.