Patient-reported efficacy and toxicity in CAR T-cell therapy for multiple myeloma via Internet-based platforms.

Authors

null

Nathan W. Sweeney

HealthTree Foundation, Lehi, UT

Nathan W. Sweeney , Eduardo Franco Hernandez , Nolan Cole , Scott Ryan Goldsmith , Zachary Crees , Jenny Ahlstrom

Organizations

HealthTree Foundation, Lehi, UT, Washington University School of Medicine, St. Louis, MO

Research Funding

Other
Private donations

Background: Chimeric antigen receptor (CAR) T-cell therapies are in clinical development for multiple myeloma (MM). Patient-reported outcomes (PRO) can provide valuable insights into how patients perceive the relative risks and benefits of these new therapies. This study aimed to evaluate CAR T-cell therapy in relapsed/refractory MM (RRMM) patients. Methods: We utilized HealthTree Cure Hub for Multiple Myeloma to analyze patient-reported data from 17 patients who participated in CAR T-cell clinical trials. In this study, we examined total prior lines of therapy, time to next treatment (TNT), overall survival (OS), patient-reported toxicity and severity, and patient-reported outcomes (myeloma reduction or no myeloma reduction). The Kaplan-Meier model was used to calculate overall survival. The severity of toxicity was assessed using a 1 to 10 scale (1 = minimal and 10 = severe). Results: Our analysis of the 17 patients found a median of 10 lines of therapy prior to CAR T-cell treatment. Ten patients had no new treatments to report at the time of this study, 5 patients reported new treatment with a median TNT of 15.9 months, and for 2 patients we did not have data. The median OS was 24 months (95% CI 21-30 months). The probability that a patient remained alive at 2 years was 0.48 (95% CI: 0.195, 1). Four of the 17 patients died with a median of 22.5 months post-CAR T-cell therapy. Two of these patients died without reporting a change in treatment. There was a total of 36 different side effects reported by patients as a result of the therapy. Table lists the side effects experienced by 2 or more patients and the corresponding average severity. Finally, 76% of patients treated with CAR T-cell therapy reported a reduction in their myeloma, four of these patients had m-protein levels reported and saw an average decrease of 93%. Of the remaining patients, three (18%) reported little to no reduction in their myeloma, and one patient (6%) did not know their response at the time of this analysis. Conclusions: Our investigation of patient-reported results suggests an emerging and viable immunotherapy treatment option for RRMM, with encouraging outcomes and manageable side effects. Future directions include analysis of genetics and treatment options post CAR T-cell therapy. These data highlight the expedited benefit of using PROs via an online platform, like HealthTree Cure Hub, to assess new therapeutics in the research community.

Side EffectFrequencySeverity Average (1-10)
Neutropenia or low lymphocyte93
Anemia73.6
Fatigue73.9
Fever/chills73.1
Thrombocytopenia63.7
Hypotension41.3
Lack of appetite41.8
Nausea33.3
Decreased weight33
Headaches31
Diarrhea33.3
Low white blood cells - Granulocytes31.3
Muscle weakness22.5
Bone pain24.5
Joint pain24.5
Difficulty - speaking23
Cough25
Dyspnea26.5
Pneumonia/bronchitis28.5
Gas/bloating21.5
Hair loss25.5
Upper respiratory Infection27.5

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Abstract Details

Meeting

2021 ASCO Annual Meeting

Session Type

Publication Only

Session Title

Publication Only: Hematologic Malignancies—Plasma Cell Dyscrasia

Track

Hematologic Malignancies

Sub Track

Multiple Myeloma

Citation

J Clin Oncol 39, 2021 (suppl 15; abstr e20024)

DOI

10.1200/JCO.2021.39.15_suppl.e20024

Abstract #

e20024

Abstract Disclosures

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