Innovation in cancer treatment is accelerating at an extraordinary pace, with breakthroughs that would have been unimaginable a generation ago. Researchers are identifying new targets, developing more precise therapies and better understanding how genetic risk factors impact a patient's disease and outcomes.

Treatment for chronic lymphocytic leukemia (CLL), the most common type of leukemia in adults, is a prime example. Over the last decade, personalized therapies have transformed CLL care, increasing five-year survival rates to nearly 90 percent. Despite this progress, too many patients still face barriers to accessing treatments that could improve their outcomes.

Here's why: A lack of access to biomarker testing, restrictive insurance barriers, inconsistent use of clinical guidelines, limited access to CLL expertise and scientifically accurate information, and affordability challenges can prevent patients from receiving targeted therapies.

To better understand gaps in CLL care, a first-of-its-kind national report commissioned by BeOne Medicines, a global oncology company, developed with leading blood cancer experts, and published by Charles River Associates highlights the barriers patients face when trying to access evidence-based, patient-centered CLL care and support.

• "People living with CLL have more treatment options than ever before, yet too many still face barriers to accessing the care they need, from biomarker testing and restrictive insurance policies like step therapy to scientifically accurate information and CLL expertise. Closing these gaps will require policymakers, healthcare leaders and the blood cancer community to work together to improve patient access," said Steve Bloom, president and chair of CLL Society.

Why it's important: Patients can fully benefit from innovative treatments only when the barriers to treatment access are understood and reduced. This report draws on academic and policy research, and from interviews from across the blood cancer community, to identify persistent gaps between innovation and access in CLL care.

The background: CLL is most commonly diagnosed in older adults, around 72 years of age. The disease typically progresses slowly and can present differently from one patient to another, making treatment decisions highly individualized.

• Factors such as biomarker testing results, genetic risk factors, age, comorbidities such as cardiovascular disease and hypertension, medications and patient preferences can all influence treatment decisions, outcomes and survival.
• The FDA approval of Bruton's tyrosine kinase (BTK) inhibitors in 2014 and B-cell lymphoma 2 (BCL-2) inhibitors in 2016 marked a shift away from chemotherapy toward targeted, personalized treatments that have significantly improved outcomes for CLL patients.

Here's the deal: As CLL treatments continue to advance, ensuring patients can access these innovations must remain a top priority.

Five key actions to close gaps in CLL care:

1. Ensure all patients have timely access to clinically appropriate biomarker testing.

• CLL biomarker testing coverage should be expanded across both state-regulated and self-funded employee health plans, and Congress should require federally regulated plans to streamline the prior authorization process.

2. Increase healthcare provider and patient education on the latest treatments and guideline-informed care.

• Healthcare systems should make decisions based on the latest scientific data, ensure biomarker testing before making treatment decisions, and provide access to CLL expertise during the treatment decision process.

3. Improve care coordination and timely access to CLL specialists.

• Expand the use of telehealth in cancer, especially for patients in rural and underserved communities, and increase investments in programs supporting rural hospitals and health systems that have limited access to oncology services.

4. Reduce insurance and pharmacy benefit manager (PBM) barriers that delay or deny access to recommended therapies.

• Policymakers should reform step therapy and prior authorization requirements that delay or restrict care and strengthen exceptions so patients aren't forced to fail or try older, less effective treatments first.

5. Increase transparency and promote responsible use of AI in cancer care.

• Support the responsible use of AI to help patients access trusted, scientifically accurate information, while requiring insurers to disclose when AI is used in coverage decisions and ensure qualified clinician oversight of care denials.

The takeaway: Expanding access to biomarker testing, reducing insurance barriers that delay or deny treatment, improving care coordination and access to blood cancer experts, and promoting transparency in AI use can help more CLL patients benefit from the most effective, targeted treatments.

Read the full report here.