OBJECTIVES:

Six Chimeric Antigen Receptor-T (CAR-T) therapies have been approved as treatments in relapsed/refractory (R/R) B-cell malignancies since 2017. This study aims to examine patient counts and characteristics of patients on CAR-T therapies in healthcare organizations in the United States covered by the TriNetX network, an electronic medical records (EMR) database.

METHODS:

Patients using CAR-T therapies were identified using RxNorm, ICD-10-PCS, and HCPCS codes between Aug 31,2017 (day after approval of first CAR-T therapy, Kymriah® by the FDA) to Jan 13, 2023. Patient counts, demographics, and co-medications were analyzed.

RESULTS:

Since August 31, 2017, 1,462 patients have been administered CAR-T therapies (Kymriah®, n=385; Yescarta®, n=729; Tecartus®, n=119; Abecma®, n=132; Breyanzi®, n=84; Carvykti®, n=13 patients).

Mean age of the cohort was 55 years, 63% were males, and 79% were white. In line with CAR-T indications, 98% of the cohort were diagnosed with ‘malignant neoplasms of lymphoid, hematopoietic and related tissue’ (ICD-10-CM: C81 through C96). At any time prior to their CAR-T therapy, 68% of the cohort was administered cyclophosphamide, 62% fludarabine, 40% rituximab, and 28% doxorubicin.

Use of Kymriah® and Yescarta® as the earliest CAR-T therapies has steadily increased over the years (Kymriah®: n=36 in 2017-2018 to n=76 in 2021-Jan 13, 2023; Yescarta®: n=40 in 2017-2018 to n=261 in 2021-Jan 13, 2023).

Specifically for Yescarta®, almost all patients (93% of the cohort) were diagnosed with ‘Diffuse Large B-cell Lymphoma’ (ICD-10-CM: C83.3). Patients administered with Kymriah® were diagnosed with different indications (54% with ‘Acute Lymphoblastic Leukemia (ICD-10-CM: C91.0), 38% with ‘Diffuse Large B-cell Lymphoma (ICD-10-CM: C83.3)).

CONCLUSIONS: With the use of CAR-T therapies steadily increasing over time, increasing availability of real-world EMR data will allow more robust understanding of patient characteristics, and real-world use and treatment patterns of CAR-Ts.