High Incidence of Financial Strain Among Caregivers and Patients Undergoing CAR-T Therapy

Financial Toxicity Among Young Adults and Families Undergoing CAR-T Therapy: A Growing Concern

Chimeric antigen receptor T-cell (CAR-T) therapy has significantly altered the treatment paradigm for relapsed or refractory B cell malignancies, demonstrating remarkable efficacy in improving patient outcomes. However, a recent study presented at the 2025 American Society of Clinical Oncology (ASCO) Annual Meeting has shed light on an urgent issue: financial toxicity among young adult patients and families of pediatric patients receiving this advanced form of treatment.

In the study led by Dr. Daniel Zheng and his colleagues from the Children’s Hospital of Philadelphia, the researchers aimed to delineate the themes and extent of financial toxicity experienced by these patients. Financial toxicity refers to the economic burden and stress that can arise from medical treatment costs, which can heavily impact patients and their families, both financially and emotionally.

The research engaged a total of 144 patients along with 136 caregivers, who were invited to complete the Comprehensive Score for Financial Toxicity (COST) assessment at various stages—before CAR-T therapy, and at one and three months after treatment. Notably, the respondents included caregivers of patients below 18 years old and the patients themselves if they were 18 or older.

The results were striking. A staggering 94% of caregivers reported experiencing financial toxicity, with a median baseline COST score of 20.0, indicative of grade 1 financial toxicity. Moreover, approximately two-thirds of patients self-identified as experiencing some level of financial toxicity, with reported grades ranging from 1 to 3.

The implications of financial toxicity are profound, as highlighted in the study’s findings. While 80% of participants developed cytokine release syndrome (CRS) as a side effect, there was no correlation between the incidence of CRS or treatment response at 28 days and financial toxicity levels. Importantly, among a subset of 80 patients monitored for at least three months, only a slight decrease in the median COST score was observed post-treatment, with 23% and 25% of patients reporting increased financial distress at one and three months, respectively.

Dr. Zheng and his team emphasized the pressing need for targeted interventions to alleviate the escalating financial burden faced by families undergoing CAR-T therapy. “For a notable proportion of families, financial toxicity worsens over time and highlights the need for interventions to address cumulative financial burden,” they concluded.

As CAR-T therapy continues to evolve and become more integrated into treatment plans for blood cancers, healthcare systems and policymakers must address the financial implications for patients and their families. Strategies may include improved access to financial counseling, support services, and insurance navigation to help mitigate the economic impact of this potentially life-saving therapy.

Disclosure: Some authors of the study have reported affiliations with biotechnology and pharmaceutical companies. For a detailed list of disclosures, readers are encouraged to refer to the original study.

This research underscores a critical issue that warrants further attention and action in the oncology community to ensure that the financial responsibilities accompanying innovative treatments do not overshadow their therapeutic benefits.