Outcomes of Outpatient Administration of Ciltacabtagene Autoleucel (Cilta-Cel) in Relapsed Refractory Multiple Myeloma (RRMM)
Author(s)
Tara Gregory, MD1, Kevin C De Braganca, MD2, Victoria Alegria, MS3, Matthew Perciavalle, PharmD4, Ravi Potluri, MBA5, Sandip Ranjan, M Tech6, Todd Bixby, RPh3, Zaina P. Qureshi, MPH, MS, PhD7;
1Colorado Blood Cancer Institute, Denver, CO, USA, 2Janssen Research & Development, Horsham, PA, USA, 3Janssen Scientific Affairs, LLC, Horsham, PA, USA, 4Legend Biotech USA, Inc, Somerset, NJ, USA, 5Putnam Associates, New York, NY, USA, 6Putnam Associates, Gurugram, India, 7Janssen Scientifi c Affairs, LLC, Horsham, PA, USA
1Colorado Blood Cancer Institute, Denver, CO, USA, 2Janssen Research & Development, Horsham, PA, USA, 3Janssen Scientific Affairs, LLC, Horsham, PA, USA, 4Legend Biotech USA, Inc, Somerset, NJ, USA, 5Putnam Associates, New York, NY, USA, 6Putnam Associates, Gurugram, India, 7Janssen Scientifi c Affairs, LLC, Horsham, PA, USA
Presentation Documents
OBJECTIVES: Ciltacabtagene autoleucel (cilta-cel), as with other CAR-T therapies, is typically administered in an inpatient setting. There is however increasing interest in outpatient administration to reduce healthcare costs and improve patient quality of life. This review aims to assess whether outpatient administration yields comparable outcomes.
METHODS: A systematic literature review was conducted through October 1, 2024, to identify literature on outpatient and inpatient use of cilta-cel in patients with multiple myeloma. No restrictions were applied on study type or geography. Retrieved records were screened against pre-defined PICOS criteria.
RESULTS: Forty-six relevant publications were identified. Three studies (all real-world observational) involved cilta-cel administration in the outpatient setting - Waqar et al. included and reported outcomes separately for both inpatient (N=6) and outpatient (N=27) settings; Gregory et al. involved both settings (N=57; 37 outpatient, 20 inpatient) but reported only consolidated outcomes; Ly et al. involved only outpatient setting (N=24).ORR of cilta-cel was reported to be 95% in Ly et al. and 82% in Gregory et al., compared to 70-100% in studies based on administration in the inpatient setting. PFS at one year was 86% in Waqar et al. for outpatient administration, vs. 59-94% in the inpatient setting. OS rate at one year was 96% (outpatient) vs. 78-94% (inpatient).Any grade CRS was reported to be 79% in Ly et al. vs. 60%-100% in inpatient administration (immune effector cell-associated neurotoxicity syndrome 17% vs. 2-33%).One study reported cost savings of $18,922 per cilta-cel treated patient in the outpatient setting, while another showed lower cost per complete responder and cost per month in PFS.
CONCLUSIONS: Upon instituting recommended processes, outpatient administration and management of cilta-cel has been shown to produce clinical outcomes comparable to traditional inpatient administration, while resulting in cost savings and without additional safety concerns.
METHODS: A systematic literature review was conducted through October 1, 2024, to identify literature on outpatient and inpatient use of cilta-cel in patients with multiple myeloma. No restrictions were applied on study type or geography. Retrieved records were screened against pre-defined PICOS criteria.
RESULTS: Forty-six relevant publications were identified. Three studies (all real-world observational) involved cilta-cel administration in the outpatient setting - Waqar et al. included and reported outcomes separately for both inpatient (N=6) and outpatient (N=27) settings; Gregory et al. involved both settings (N=57; 37 outpatient, 20 inpatient) but reported only consolidated outcomes; Ly et al. involved only outpatient setting (N=24).ORR of cilta-cel was reported to be 95% in Ly et al. and 82% in Gregory et al., compared to 70-100% in studies based on administration in the inpatient setting. PFS at one year was 86% in Waqar et al. for outpatient administration, vs. 59-94% in the inpatient setting. OS rate at one year was 96% (outpatient) vs. 78-94% (inpatient).Any grade CRS was reported to be 79% in Ly et al. vs. 60%-100% in inpatient administration (immune effector cell-associated neurotoxicity syndrome 17% vs. 2-33%).One study reported cost savings of $18,922 per cilta-cel treated patient in the outpatient setting, while another showed lower cost per complete responder and cost per month in PFS.
CONCLUSIONS: Upon instituting recommended processes, outpatient administration and management of cilta-cel has been shown to produce clinical outcomes comparable to traditional inpatient administration, while resulting in cost savings and without additional safety concerns.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
CO204
Topic
Clinical Outcomes
Topic Subcategory
Clinical Outcomes Assessment
Disease
SDC: Oncology