CAR-T Trial Access Significantly Lower for People Living With HIV, Study Finds
核心洞察
A cross-sectional study found only 13.8% of CAR-T (搜索) clinical trials for non-Hodgkin lymphoma (搜索) explicitly include people living with HIV (搜索), while 72.5% exclude them.
People living with HIV (搜索) face median travel times of 1.15 hours to HIV-inclusive trials versus 0.73 hours for the general trial population.
Access within one hour was 46.07% for HIV (搜索)-inclusive studies compared with 55.27% for HIV-exclusive studies (P<0.001).
CAR-T (搜索) clinical trials for non-Hodgkin lymphoma (搜索) remain significantly less accessible to people living with HIV (搜索), according to a new cross-sectional study published in JAMA that identified substantial disparities in both trial eligibility and geographic access compared with the wider population.
Researchers analysed interventional CAR-T (搜索) clinical trials for non-Hodgkin lymphoma (搜索) listed on ClinicalTrials.gov that were actively recruiting adult participants in the contiguous United States as of May 2025. Of 254 eligible studies reviewed, 80 met the inclusion criteria for the analysis.
Limited Inclusion in Trial Eligibility Criteria
Among the 80 trials evaluated, only 11 (13.8%) explicitly included people living with HIV (搜索), while 58 (72.5%) excluded them entirely. A further 11 trials (13.8%) made no mention of HIV status in their eligibility criteria, leaving uncertainty about access for this patient population.
The study, led by Maillie and colleagues, assessed access by calculating population-weighted travel times to the nearest trial site using geographical data from participating centres across the contiguous United States.
Significant Travel Burden Disparities
The analysis revealed that people living with HIV (搜索) faced meaningfully greater travel burdens when seeking access to CAR-T (搜索) clinical trials. The median population-weighted travel time for HIV-inclusive trials was 1.15 hours, compared with 0.84 hours for trials excluding people living with HIV and just 0.73 hours for the general trial population.
Access within one hour was substantially lower for HIV (搜索)-inclusive studies compared with HIV-exclusive studies: 46.07% versus 55.27% (P<0.001). Similar disparities were observed when evaluating access within three hours: 82.22% for HIV-inclusive trials versus 87.76% for HIV-exclusive trials (P<0.001).
Southern United States Bears Greatest Burden
The most pronounced access gap was identified in the southern United States, a region with a high prevalence of HIV (搜索). In this area, the median travel time to the nearest HIV-inclusive CAR-T (搜索) clinical trial was 1.70 hours, compared with 0.92 hours for HIV-exclusive studies (P<0.001). This regional disparity compounds the already significant barriers faced by people living with HIV in this geography.
Unmet Need Despite Therapeutic Advances
CAR-T (搜索) therapy has transformed the treatment landscape for non-Hodgkin lymphoma (搜索), yet people living with HIV (搜索) continue to encounter barriers to participation in clinical research. The findings suggest that efforts to reduce exclusion based solely on HIV status have not fully translated into equitable access to CAR-T clinical trials.
The authors concluded that additional strategies are needed to improve trial availability and participation opportunities for underserved populations, particularly people living with HIV (搜索), who remain underrepresented despite facing a substantial burden of lymphoma-related mortality.