Household income

• Financial toxicity / out-of-pocket burdenHigh

  Below poverty, even modest out-of-pocket costs force impossible trade-offs that can derail treatment

• Travel & lodging burdenWatch

  Below poverty, front-loaded travel and lodging costs are often simply unaffordable without assistance lined up first

• Equity / disparity riskWatch

  Low income stacks travel, lodging, time-off, and coverage hurdles that each thin the odds of finishing care

• Housing insecurity / relocation burdenWatch

  On a low income, paying for weeks of lodging away from home is usually out of reach without help

Disease pace

• Late referral / progression before treatmentHigh

  Fast-moving disease can outrun the refer-and-work-up timeline, so any delay risks losing the treatment window

• Eligibility / patient-selection hurdlesModerate

  Rapid progression can erode fitness mid-work-up, so someone eligible today may not be by the time they are assessed

• Manufacturing / collection & vein-to-vein riskModerate

  The 2–8 week manufacturing wait is hard to survive when disease is moving fast, which makes strong bridging therapy critical

Center network status

• Single-case agreement / out-of-networkModerate

  Out-of-network care requires negotiating a single-case agreement before treatment — often several weeks of back-and-forth

• Insurance coverage & prior-authorizationWatch

  An out-of-network center means standard authorization doesn't apply — a special agreement has to be arranged first

Line of therapy

• Late referral / progression before treatmentHigh

  With 2+ lines already used, the window to refer while still eligible is closing

Dedicated caregiver (~30 days)

• Caregiver & psychosocial clearanceHigh

  An unconfirmed caregiver can hold up psychosocial clearance until a concrete, named plan is in place

Caregiver & work

• Caregiver & psychosocial clearanceHigh

  If the caregiver can't take ~a month of leave without losing income, the required round-the-clock coverage can fall through

Financial cushion

• Financial toxicity / out-of-pocket burdenHigh

  With little savings, one unexpected bill or lost paycheck can halt participation mid-course

Living situation

• Caregiver & psychosocial clearanceHigh

  Living alone means no built-in caregiver, so one has to be recruited to meet the requirement

Performance status

• Eligibility / patient-selection hurdlesModerate

  ECOG 3–4 is a common exclusion, so this patient may be declined unless the team pushes to optimize fitness first

Transportation

• Transportation barrierWatch

  Depending on others or transit makes frequent, time-sensitive visits fragile — a missed ride becomes a missed step