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Communication About Chimeric Antigen Receptor T-Cell (CAR-T) Therapy
Tejaswini Dhawale1, P Connor Johnson1, Kofi Boateng2
1Department of Medicine, Division of Hematology & Oncology, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Cancer Outcomes Research and Education Program, Massachusetts General Hospital, Boston, Massachusetts.
Oncologist communication about Chimeric Antigen Receptor T-cell (CAR-T) therapy often emphasizes positive outcomes, leaving patients and caregivers with knowledge gaps regarding risks and uncertainties. Further research is needed to improve discussions on treatment failures and toxicities.
Area of Science:
- Oncology
- Hematology
- Patient Communication
Background:
- Chimeric Antigen Receptor T-cell (CAR-T) therapy offers a revolutionary treatment for hematologic malignancies.
- Life-threatening toxicities can accompany CAR-T therapy.
- Limited research exists on how oncologists communicate CAR-T therapy risks and benefits to patients and caregivers.
Purpose of the Study:
- To characterize oncologist communication content regarding CAR-T therapy risks and benefits.
- To explore patient and caregiver information preferences for CAR-T therapy consent.
Main Methods:
- A multimethod study involving 20 patients and 10 caregivers undergoing CAR-T therapy referral.
- Audio recording of initial consent visits, post-consent surveys, and follow-up interviews at 1 and 3 months post-treatment.
- Qualitative data analysis using the framework approach.
Main Results:
- Oncologists often frame CAR-T therapy with innovation and positive outcomes, downplaying uncertainties and failures.
- Discussions of risks are frequently paired with assurances of mitigation strategies.
- Patients and caregivers generally prefer a positive discourse but report significant knowledge gaps concerning advanced care planning, treatment failure, and toxicities.
Conclusions:
- Despite feeling informed, patients and caregivers experience communication gaps regarding negative CAR-T therapy outcomes.
- A predominantly positive communication style may hinder preparedness for adverse events.
- Further research should focus on enhancing oncologist communication about treatment uncertainties and negative outcomes.
