Long-Term Financial Toxicity After CAR T-Cell Therapy Among Patients in Remission and Their Caregivers

The long-term financial toxicity for patients who received Chimeric Antigen Receptor (CAR) T-cell therapy and their caregivers remains under-explored. The aim of this research is to describe the financial toxicity of patients who are in remission one to five years after receiving CAR T-cell therapy and their caregivers and explore associations between social determinants of health (SDoH), clinical factors, and health-related quality of life (HRQoL) with financial toxicity. This cross-sectional study included adults who had received CAR T-cell therapy for a hematologic malignancy and their current or former informal caregivers. Patients and caregivers completed measures of financial toxicity, HRQoL, and a demographic survey, while patients also completed cognitive function and symptom burden measures. Descriptive and bivariate statistics were used in this exploratory analysis. There were 58 patients and 31 caregivers study participants. Financial toxicity was relatively low, 25% of patients reported mild to moderate and 18% of caregivers reported mild to severe financial toxicity. Patient financial toxicity was significantly associated with patient income, HRQoL domains, the mental HRQoL summary score, and symptom burden. Caregiver financial toxicity was significantly associated with caregiver age, employment status, HRQoL domains, and the mental HRQoL summary score. Patients and caregivers reported low levels of financial toxicity in the present study: A majority of patients (75%) and caregivers (81%) experienced zero to minimal financial toxicity. Certain patients and caregivers at higher risk for financial toxicity may benefit from targeted interventions coupled with supportive care to address other HRQoL needs.