A new analysis presented at the 2024 ASH Annual Meeting reveals significant travel burden disparities among patients receiving different bispecific antibody treatments for relapsed/refractory diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma. The study highlights particular challenges associated with epcoritamab-bysp (Epkinly) compared to alternative treatments.
Travel Burden Analysis Findings
Medicare claims data analysis showed patients traveled an average of 80.1 miles (median 23.7 miles) each way for bispecific antibody therapy. While 56% of patients traveled less than 30 miles, a significant 24% needed to travel over 60 miles each way for treatment.
For DLBCL patients, the cumulative 12-month travel distances varied substantially between treatments:
- Epcoritamab: 4,486 total miles
- Glofitamab: 2,243 total miles This difference resulted in an additional 40 hours of travel time for epcoritamab patients.
Similarly, follicular lymphoma patients faced varying travel burdens:
- Epcoritamab: 4,486 miles
- Full-course mosunetuzumab: 3,044 miles
- Short-course mosunetuzumab: 1,602 miles (for complete responders after 8 cycles)
Impact on Patient Care
Dr. Zachary Frosch, assistant professor at Fox Chase Cancer Center, emphasized the concept of "time toxicity" - the significant time patients spend seeking, receiving, and coordinating care. "Travel burden to receive bispecific antibody therapies can be significant for patients," noted Dr. Frosch.
Multiple factors compound these challenges:
- Disease-related illness and comorbidities
- Transportation access limitations
- Social support availability
- Financial considerations
Clinical Implications
The findings underscore the importance of considering travel burden when making treatment decisions. Healthcare providers are encouraged to:
- Discuss patient priorities regarding travel and time commitments
- Consider treatment options based on individual circumstances
- Evaluate possibilities for delivering portions of care closer to home
- Address potential financial barriers
The study authors suggest that understanding these burdens and costs will help healthcare providers and patients make more informed therapy decisions aligned with personal treatment goals. This becomes particularly crucial for patients with limited resources or those experiencing financial hardship, as these factors can significantly impact treatment adherence.
