Chimeric antigen receptor T-cell treatment patterns in relapsed or refractory large B-cell lymphoma

Abstract

Aim: To investigate real-world chimeric antigen receptor (CAR) T-cell therapy treatment patterns. Patient & methods: Relapsed/refractory large B-cell lymphoma patients who received CAR T-cell therapy were identified. Patient characteristics, setting of CAR T-cell infusion, incidence of CAR T-cell therapy-associated adverse events and healthcare resource utilization were assessed. Results: Of 1175 patients, 83% were infused inpatient. Within three days postinfusion, inpatient-infused patients had a significantly higher risk of CAR T-associated adverse events (hazard ratio: 2.67; 95% CI: 2.09–3.42) compared with outpatient-infused patients. By day 30, 67% of outpatient-infused patients were hospitalized at least once. Conclusion: These findings suggest that physicians were able to select lower-risk patients for outpatient infusion, but postinfusion hospitalizations still occur.

Plain language summary

Real-world treatment patterns after chimeric antigen receptor T-cell therapy among patients with relapsed or refractory large B-cell lymphomaThis study tracks outcomes in patients with relapsed/refractory large B-cell lymphoma who received chimeric antigen receptor (CAR) T-cell therapy between 2017 and 2020. The authors used the Anlitiks All-Payor Claims (AAPC) database, which includes insurance claims of patients covered through Medicare, Medicaid or commercial insurance plans. AAPC includes over 80% of insured patients in the USA healthcare system. The study describes where patients received CAR T-cell therapy (inpatient/outpatient), rates of adverse events potentially related to CAR T-cell treatment and how much healthcare the patients received. In the 3 days after receiving CAR T-cell therapy, rates of CAR T-associated adverse events were significantly higher in patients who received CAR T-cell therapy in the inpatient setting, compared with outpatients. The findings suggest that lower-risk patients may receive CAR T-cell therapy as outpatients, but that most outpatient-infused patients will still require inpatient care.

Keywords::

• CAR T-cell therapy
• large B-cell lymphoma
• refractory
• relapsed
• retrospective analysis
• treatment patterns

Supplementary data

To view the supplementary data that accompany this paper please visit the journal website at: www.futuremedicine.com/doi/suppl/10.2217/fon-2023-0140

Author contributions

All authors made substantive contributions to the study design and results interpretation for this work. JT Snider, R Seyedin, K Rajagopalan and SW Wade guided and/or conducted the data analysis and U Gergis provided clinical expertise throughout the study. R Seyedin developed the initial draft manuscript and all authors reviewed and provided critical revisions, along with approval of the final manuscript.

Financial & competing interests disclosure

Funding for this work was provided by Kite, a Gilead company. U Gergis serves on the speaker bureau and reports consultancy for Kite/Gilead. SW Wade, K Rajagopalan and R Seyedin report consultancy for Kite/Gilead. JT Snider reports employment and stock options from Kite/Gilead. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this work.

Previous presentation

Selected results from this study were presented at the American Society for Hematology 2021 Annual Meeting [40].

Additional information

Funding

Funding for this work was provided by Kite, a Gilead company. U Gergis serves on the speaker bureau and reports consultancy for Kite/Gilead. SW Wade, K Rajagopalan and R Seyedin report consultancy for Kite/Gilead. JT Snider reports employment and stock options from Kite/Gilead. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.