Chimeric Antigen Receptor T-Cell (CAR-T) Therapy for Multiple Myeloma in the US: Real-World Evaluation of Patient Characteristics and Treatment Patterns
Kish J1, Pfeffer D2, Cyhaniuk A1, Lussier C1, Nayak P1, Liu R1, Prasad S1, Sehgal P1
1Eversana, Yardley, PA, USA, 2EVERSANA Life Sciences Inc., Milwaukee, WI, USA
OBJECTIVES: Chimeric antigen receptor T-cell (CAR-T) therapies are the newest approved class of therapy for multiple hematologic malignancies including multiple myeloma (MM). With nearly 2 years real-world experience we sought to examine clinical characteristics of patients who received, were waiting, or did not receive CAR-t therapy for MM.
METHODS: Patients with a MM diagnosis, age ≥18, treated or referred for either idecabtagene vicleucel (Approved 03/2021) or ciltacabtagene autoleucel (approved 02/2022) post-approval were selected from the EVERSANA EMR Database. Patient characteristics and treatment patterns were analyzed. CAR-t administration was confirmed via structured and unstructured data review.
RESULTS: Ninety-nine (99) MM patients had a treatment record or a mention of CAR-T in clinical notes. Of those, 39 received CAR-t while 60 had not. Mean months to CAR-t was 72.9 from diagnosis. Line of therapy (LOT) in which CAR-t was received: 5th = 4.2%, 6th = 29.2%, 7th/8th = 29.2%, and ≥9th = 37.5%. Comparing administered to not yet treated mean (SD) age was 61.9 (7.6) vs 63.1(8.5), 41.0% vs 31.7% were female, 35.9% vs 26.7% lived in the northeast and 46.0% vs 32.8% had CCI ≥4, respectively. Prior to receiving the CAR-T 25.6% vs 35.0% had inpatient visit, and 12.8% vs 18.3% had an ER visit, respectively. Pre-CAR-t most common regimens by LOT were: LOT1 = velcade-revlimid-dexamethasone (42%); LOT2 = velcade-cyclophosphamide-dexamethasone (15%). In LOT3 35% of patients received pomalidomide, 35% carfilzomib and 19% daratumumab. Of the 60 not yet treated, 60% had discussed CAR-t (but not referred) while 34.6% were planning, recommended, referred, registered or waiting for administration.
CONCLUSIONS: This is the first published data to describe real-world, U.S. patients with MM treated or referred for CAR-t therapy. Given the demographic and clinical heterogeneity in the real-world cohorts further exploration of outcomes is required given the highly controlled nature of the pivotal trials.
Conference/Value in Health Info
Value in Health, Volume 26, Issue 6, S2 (June 2023)
Clinical Outcomes, Study Approaches
Clinician Reported Outcomes, Electronic Medical & Health Records