Acute patient‐reported outcomes in B‐cell malignancies treated with axicabtagene ciloleucel

Hoogland, Aasha I.; Jayani, Reena; Collier, Aaron; Irizarry-Arroyo, Nathaly; Rodriguez, Yvelise; Jain, Michael D.; Booth-Jones, Margaret; Hyland, Kelly A.; James, Brian W.; Barata, Anna; Bachmeier, Christina A.; Chávez, Julio C.; Khimani, Farhad; Krivenko, Gabriel; Lazaryan, Aleksandr; Liu, Hien; Nishihori, Taiga; Pinilla‐Ibarz, Javier; Shah, Bijal; Abidi, Muneer H.; Locke, Frederick L.; Jim, Heather

doi:10.1002/cam4.3664

Cited by 20 publications

(26 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Patient-reported toxicity monitoring (measured with PRO-CTCAE) revealed peaks of symptoms such as cough, decreased appetite, dry mouth, fatigue, hair loss, hand-foot syndrome, headache, nausea, problems with concentration, problems with memory at 14 days after CAR T-cell infusion followed by decline over time. 48…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Chimeric Antigen Receptor T-cell Therapy in Hematologic Malignancies and Patient-reported Outcomes: A Scoping Review

et al. 2022

View full text Add to dashboard Cite

The inclusion of patient-reported outcome (PRO) measures in chimeric antigen receptor (CAR) T-cell therapy research is critical for understanding the impact of this novel approach from a unique patient standpoint. We performed a scoping review to map the available literature on the use of PRO measures in CAR T-cell therapy studies of patients with hematologic malignancies published between January 2015 and July 2022. Fourteen studies were identified, of which 7 (50%) were investigational early-phase trials, 6 (42.9%) were observational studies, and 1 (7.1%) was a pilot study. The EQ-5D and the PROMIS-29 were the 2 most frequently used PRO measures, being included in 6 (42.9%) and 5 (35.7%) studies, respectively. Despite differences in study designs, there seems to be evidence of improvements over time since CAR T-cell infusion in important domains such as physical functioning and fatigue, at least in patients who respond to therapy. Overall, the studies identified in our review have shown the added value of PRO assessment in CAR T-cell therapy research by providing novel information that complements the knowledge on safety and efficacy. However, there are several questions which remain to be answered in future research. For example, limited evidence exists regarding patient experience during important phases of the disease trajectory as only 4 (28.6%) and 5 (35.7%) studies provided information on PROs during the first 2 weeks from CAR T-cell infusion and after the first year, respectively. Time is ripe for a more systematic implementation of high-quality PRO assessment in future clinical trials and in real-life settings of patients treated with CAR T-cell therapy.

show abstract

Section: Resultsmentioning

confidence: 99%

“…Of these, we retrieved a total of 14 eligible studies reporting PRO results. 14,15,[45][46][47][48][49][50][51][52][53][54][55][56] Details of the search strategy and selection process of the articles included in this review were documented according to the PRISMA guidelines 57 and are reported in Figure 1.…”

Section: Data Extraction and Evaluationmentioning

confidence: 99%

Chimeric Antigen Receptor T-cell Therapy in Hematologic Malignancies and Patient-reported Outcomes: A Scoping Review

et al. 2022

View full text Add to dashboard Cite

show abstract

“…[ 19 ] Similarly, 96% of patients with hematological malignancies treated with axi-cel reported fatigue with 84% reporting moderate to severe fatigue. [ 20 ] In a study comparing patient-reported quality of life and symptom burden after CAR T-cell therapy and other forms of cellular therapy, 44% of patients in the CAR T-cell group reported fatigue after treatment. [ 21 ] Furthermore, the conditioning chemotherapy that precedes CAR T-cell therapy may cause side effects such as pancytopenia, weakness, nausea, vomiting, poor appetite, and in severe cases neuropathy in the hands and feet, affecting physical function.…”

Section: Rehabilitation Interventions For Functional Declinementioning

confidence: 99%

Rehabilitation Needs for Patients Undergoing CAR T-Cell Therapy

et al. 2022

View full text Add to dashboard Cite

Purpose of Review Chimeric antigen receptor (CAR) T-cell therapy is a relatively new, innovative treatment strategy to manage refractory hematological cancers, including some types of leukemia, lymphoma, and multiple myeloma. This article outlines the CAR T-cell therapy process, toxicity, and complications, along with an overview of the currently known short- and long-term physical and functional sequelae that will be helpful for general or oncology rehabilitation specialists caring for these patients. Recent Findings There is a dearth of literature on the topic of rehabilitation of patients receiving CAR T-cell therapy. Rehabilitation practices can be extrapolated from the limited functional information on patients who have completed treatment for lymphoma and multiple myeloma. Patients present with cognitive impairment, muscle weakness, reduced exercise capacity, neuropathy, and cancer-related fatigue. Physical activity and rehabilitation programs may be beneficial to address fatigue, psychological symptoms, and quality of life. Summary There is limited rehabilitation research in patients receiving CAR T-cell therapy. These patients may present with general deconditioning and neurological complications which translate to neuromuscular and cognitive impairment that benefit from multidisciplinary rehabilitation intervention prior to, during, and after treatment. Studies measuring the impairments at baseline and evaluation of the impact of rehabilitation practices are much needed to support this.

show abstract

“…10–13 Most patients report long-term neuropsychiatric consequences, including depression, anxiety and cognitive impairment. 11,12,14 Perspectives from patients who fail to respond or progress rapidly following treatment are lacking. 6…”

Section: Introductionmentioning

confidence: 99%

A qualitative service evaluation of patient and caregiver experiences of CAR-T therapy: Recommendations for service development and implications for palliative care teams

et al. 2022

View full text Add to dashboard Cite

Background: Chimeric Antigen-Receptor-T-cell (CAR-T) therapy is a potentially life-saving treatment for refractory haematological malignancies. Internationally, CAR-T services are undergoing rapid development. Despite this, research on the lived experiences of patients receiving novel immunotherapies is limited. Little is known about their supportive care needs. Consequently, dedicated palliative and supportive care services may not be considered. Aim: To explore the patient and caregiver experience of CAR-T therapy and identify unmet needs to inform service development. Design: A qualitative longitudinal service evaluation. Sixteen interviews were conducted between December 2020 and March 2021 with patients ( n = 10) and family caregivers ( n = 4). Thematic analysis was underpinned by a constructivist approach. Setting/participants: All patients and caregivers attending one UK centre for CAR-T therapy were eligible. Semi-structured interviews were conducted at specific time points: prior to infusion, one month after infusion and follow-up post-treatment (5–18 months). Results: Identified themes described the unique challenges of CAR-T therapy. From the point of referral patients had a wide range of supportive care needs. Initially, this was attributed to prior receipt of multiple failed treatments. Subsequently, CAR-T side-effects impacted on quality-of-life and physical function. Significant psychological morbidity from prognostic uncertainty was described throughout. Patients and caregivers reported that a dedicated nurse specialist – an expert, consistent point of contact – was essential. Conclusion: Patients and caregivers would benefit from early and ongoing support from palliative care, allied-health professionals and psychology. As indications for CAR-T therapy expand, there is an urgent need for multi-centre studies incorporating patient-reported outcome data to ensure patient-centred service delivery.

show abstract

Acute patient‐reported outcomes in B‐cell malignancies treated with axicabtagene ciloleucel

Cited by 20 publications

References 30 publications

Chimeric Antigen Receptor T-cell Therapy in Hematologic Malignancies and Patient-reported Outcomes: A Scoping Review

Chimeric Antigen Receptor T-cell Therapy in Hematologic Malignancies and Patient-reported Outcomes: A Scoping Review

Rehabilitation Needs for Patients Undergoing CAR T-Cell Therapy

A qualitative service evaluation of patient and caregiver experiences of CAR-T therapy: Recommendations for service development and implications for palliative care teams

Contact Info

Product

Resources

About