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In-person registration included the full virtual experience, and virtual-only attendees will be able to tune into live in-person sessions and/or watch captured in-person sessions on-demand in addition to having a variety of virtual-only sessions to attend.

Chimeric Antigen Receptor T-Cell Therapy (CAR-T) Utilization Patterns for Relapsed/Refractory (R/R) Diffuse Large B-Cell Lymphoma (DLBCL) Among United States (US) Community Hematologists/Oncologists (CH/OS)

Speaker(s)

Feinberg B1, Klink A2, Schuler T3, Balanean, MPH A2, McAllister L2, Liassou D2, Gajra A2, Porter D4
1Cardinal Health Specialty Solutions, ATLANTA, GA, USA, 2Cardinal Health Specialty Solutions, Dublin, OH, USA, 3Cardinal Health Specialty Solutions, Issaquah, WA, USA, 4Cell Therapy and Transplant Program, Hematology Oncology Division and Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA

Presentation Documents

OBJECTIVES:

Patients with R/R DLBCL are initially treated by cH/Os and require referral for CAR-T. Aspects of the patient’s complex journey are not well understood. This study assessed CAR-T recipient care from the cH/O perspective.

METHODS:

This was a retrospective, observational, multicenter study of R/R DLBCL CAR-T recipients in 2019. Charts were abstracted by treating cH/Os capturing treatment patterns and outcomes. Data were compared by months from initial diagnosis to CAR-T (<18 [n=29] or >18 [n=36]) using a <18-month surrogate endpoint for poor prognosis (e.g., refractory disease, rapid progression) and chi-square, Fisher exact, or t-tests. Data were also described by patients’ US regions.

RESULTS:

13 cH/Os identified 65 patients. Most (92%) received first-line R + CHOP, had median 2 pre-CAR-T therapies (range 1-4), 32% prior autologous stem cell transplantation (ASCT), 60% axicabtagene ciloleucel (axi-cel), 39% tisagenlecleucel (tisa-cel), and 2% had lisocabtagene maraleucel. Patients with >18 months between initial diagnosis and CAR-T were more likely to receive ASCT (53% vs 7%, P=0.0056) and have longer median overall survival (OS) post-CAR-T (64.8 vs 40.3 months, P=0.0488). Median times to key events for the overall sample were: referral to leukapheresis (LP), 4.6 weeks; LP to CAR-T, 3.6 weeks. Patient distributions within each US region of Northeast [NE] (n=19, 29%), Midwest [MW] (n=6, 9%), South [S] (n=14, 22%), and West [W] (n=26, 40%), respectively, were: time to CAR-T <18 months (n=29, 45%): (n=14, 74%), (n=2, 33%), (n=2, 14%), (n=11, 42%) (P=0.0056); pre-CAR-T ASCT (n=21, 32%): (n=2, 11%), (n=5, 83%), (n=10, 71%), (n=4, 15%) (P<0.0001); axi-cel (n=39, 60%): (n=9, 47%), (n=1, 17%), (n=14, 100%), (n=15, 58%) (P=0.0006); and tisa-cel (n=25, 39%): (n=10, 53%), (n=5, 83%), (n=0, 0%), and (n=10, 39%) (P=0.0006).

CONCLUSION:

Regional differences in important CAR-T patterns and outcomes were observed. Shorter OS from diagnosis to CAR-T <18 months is consistent with recent trials.

Code

CO99

Topic

Clinical Outcomes

Topic Subcategory

Clinical Outcomes Assessment

Disease

Oncology