Date of Award

January 2025

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Leah L. Ferrucci

Second Advisor

Samuel S. Katz

Abstract

Background: Chimeric Antigen Receptor (CAR) T-cell therapy is a combination of antibody and T cell receptor (TCR), which allows T-cells to recognize and attack cancer cells. It has shown effectiveness in treating hematological malignancies, but has been less effective for solid tumors. Clinically, it is the first FDA-approved gene therapy as it uses lentivirus to modify the genome of T cells that are infused back into patients. Preclinically, laboratory research is being conducted to enhance this treatment through multiple genetic modifications. Concurrently, integrating community research to understand the public’s awareness of CAR-T is essential for making this therapy more widely understood and accessible. In this pilot mixed method study, we assessed the relationship between having friends and/or family members with cancer and a person’s awareness of CAR-T therapy, and explored methods to enhance public awareness of this treatment. Methods: A cross-sectional pilot survey was conducted from May to July 2024 with 124 individuals who had lived in Connecticut, US, for at least one year. Multivariable logistic regression was used to assess the association between having friends and/or family members with a cancer diagnosis and one’s awareness of CAR-T. In July 2024, follow-up in-person or virtual interviews with five survey participants further explored their views on cancer treatments, immunotherapy, and CAR-T. The qualitative interview data were analyzed using the constant comparative method.

Results: The 124 survey participants were 39 years old on average, 43.9% male, 58.1% had at least some college education level, and 70.7% had a friend and/or family member with a cancer diagnosis. Approximately 16.1% of participants were aware of CAR-T therapy. We did not find evidence of an association between having friends and/or family members with a cancer diagnosis and one’s awareness of CAR-T therapy (odds ratio (OR) = 1.97, 95% confidence interval (CI): 0.47–8.17). The qualitative data revealed that effective communication from clinicians and researchers was important to the participants’ understanding and being open to use of CAR-T as a cancer treatment option.

Conclusion: CAR-T is a highly effective novel treatment for cancer that has a rapidly expanding role in clinical practice. Despite its promise and rapid adaptation into clinical protocols, our findings suggest that there is limited public awareness of CAR-T. Therefore, there is a need for researchers to educate the public about CAR-T, so that this therapy is better understood and seen as a potentially acceptable therapy for certain cancers. This will help to ensure basic science research on CAR-T is as impactful as possible for patients in the future.

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This is an Open Access Thesis.

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