Patient-reported quality of life (QOL) following CTL019 in pediatric and young adult patients (pts) with relapsed/refractory (r/r) b-cell acute lymphoblastic leukemia (B-ALL).

Authors

null

Andrew Charles Dietz

Children’s Center for Cancer and Blood Diseases, Children’s Hospital Los Angeles, University of Southern California, Los Angeles, CA

Andrew Charles Dietz , Stephan A. Grupp , Theodore Willis Laetsch , Heather Stefanski , Gary Douglas Myers , Henrique Bittencourt , Jochen Buechner , Eneida R. Nemecek , Paul L. Martin , Hidefumi Hiramatsu , Francoise Mechinaud , Gregory A. Yanik , Barbara De Moerloose , Patricia Ann Wood , Lawrence Rasouliyan , Yiyun Zhang , Simu K. Thomas , Sweta Shah , Andrew Harris

Organizations

Children’s Center for Cancer and Blood Diseases, Children’s Hospital Los Angeles, University of Southern California, Los Angeles, CA, Center for Childhood Cancer Research, Children’s Hospital of Philadelphia, Philadelphia, PA, The University of Texas Southwestern, Children’s Health, Dallas, TX, Department of Pediatric Blood and Marrow Transplant, University of Minnesota, Minneapolis, MN, Division of BMT/Hematology/Oncology, Children’s Mercy Kansas City, Kansas City, MO, Hematology-Oncology Division, CHU Sainte-Justine, Université de Montréal, Montréal, QC, Canada, Department of Pediatric Oncology and Hematology, Oslo University Hospital, Oslo, Norway, Bone Marrow Transplantation Program, Oregon Health & Science University, Portland, OR, Division of Pediatric Blood and Marrow Transplant, Duke University Medical Center, Durham, NC, Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan, Children's Cancer Centre, The Royal Children's Hospital Melbourne, Melbourne, Australia, Department of Pediatrics, University of Michigan Medical Center, Ann Arbor, MI, Department of Pediatrics, Ghent University Hospital, Ghent, Belgium, Novartis Pharmaceuticals Corporation, East Hanover, NJ, RTI Health Solutions, Barcelona, Spain, Department of Pediatrics, University of Utah, Salt Lake City, UT

Research Funding

Pharmaceutical/Biotech Company

Background: The global ELIANA trial (NCT02435849) evaluates the efficacy and safety of CTL019, a single infusion of genetically modified autologous chimeric antigen receptor–expressing T cells targeting CD19+ cells in pediatric and young adult r/r B-ALL pts. Analyses show a complete response rate of 82% with or without complete blood count recovery ≤ 3 months. A serious adverse event rate of 71% was observed in ≤ 8 weeks of infusion, decreasing to 17% at > 8 weeks (Grupp S, et al. Blood. 2016;128(22) [abstract 221].). This analysis further evaluates the clinical benefit of CTL019. QOL was assessed before and after CTL019 infusion. Methods: Infused pts were 3-23 y/o with CD19+ B-ALL who were chemo refractory, relapsed after allogeneic stem cell transplant (SCT), or otherwise ineligible for SCT. Pts ≥ 8 y completed the Pediatric Quality of Life Inventory (PedsQL) and EuroQol EQ-5D at baseline and following CTL019 infusion. Minimal clinically important differences are estimated to be 4.4 and 7 to 10 for PedsQL and EQ-5D, respectively. Results: 62 of 81 enrolled pts were infused; 56% had relapsed after SCT with median of 3 prior therapies. At interim analysis, 50 pts were treated ≥ 3 months prior to data cutoff and eligible for primary efficacy analysis. A total of 39 pts were ≥ 8 y. Mean PedsQL total and EQ-5D VAS scores, respectively, were 58.4 and 69.4 at baseline. Mean changes from baseline for the PedsQL total and EQ VAS scores, respectively, were 13.9 and 13.7 at month 3 and 12.8 and 10.9 at month 6, supporting clinically meaningful improvements in QOL. Similar trends were observed with each PedsQL subscale. With EQ-5D, the proportions of pts reporting problems with mobility, self-care, usual activities, anxiety/depression, or pain/discomfort were notably decreased at months 3 and 6 compared with baseline. Conclusions: Clinically meaningful improvements in QOL were observed at 3 and 6 months after CTL019 therapy in pediatric and young adult r/r B-ALL pts, including fewer problems in each EQ-5D domain. These results suggest improved QOL after this one-time immunocellular therapy beyond the period of acute toxicities. Clinical trial information: NCT02435849

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Abstract Details

Meeting

2017 ASCO Annual Meeting

Session Type

Poster Discussion Session

Session Title

Pediatric Oncology

Track

Pediatric Oncology

Sub Track

Leukemia/Lymphoma

Clinical Trial Registration Number

NCT02435849

Citation

J Clin Oncol 35, 2017 (suppl; abstr 10523)

DOI

10.1200/JCO.2017.35.15_suppl.10523

Abstract #

10523

Poster Bd #

280

Abstract Disclosures