October 8, 2025

Treatment selection preferences and barriers in relapsed or refractory large B-cell lymphoma.

Key Points

Providers showed a strong preference for CAR-T over bispecific antibodies based on perceived better outcomes.
Fifty-five percent cited perceived better outcomes as a reason for favoring CAR-T compared to logistical barriers for BsAb at specialized centers.
Treatment decisions were largely influenced by response rates, survival, and the toxicity profile rather than cost and logistical factors.
Access barriers remain a significant concern despite the preference for CAR-T, suggesting a need for improved healthcare resource management.

Abstract

207 Background: CAR-T p = 0.03) p = 0.001). Even at BsAb-only centers, preference leaned toward CAR-T, though notably lower compared to CAR-T centers. Among centers without either, 86% preferred CAR-T. Practice volume had no impact. Reasons for favoring CAR-T included perceived better outcomes (55%), shorter treatment (26%), center choice (19%), more experience (48%), p < 0.0001) for similar reasons. Among BsAb, Epcoritamab was favored by 56% for administration ease (subcutaneous), experience, Glofitamab by 42% for shorter duration, experience, p < 0.0001). For relapse after second-line CAR-T, 78% providers preferred BsAb as the next line over other options ( p < 0.0001) due to more favorable response rates, toxicity profile, & experience with use. Providers prioritized response rates, survival, & toxicity profile in their treatment decisions. Logistics, duration, frequency, & cost were less important. There were no differences based on practice setting & CAR-T experience. Conclusions: Despite higher preference for CAR-T due to perceived superior outcomes, access barriers exist. Efforts to streamline referral pathways, logistics, & expand availability are crucial to improve outcomes.

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