Association Between Patient-Reported Outcomes Prior to Chimeric Antigen Receptor (CAR) T-Cell Therapy and Clinical...

Area of Science:

• Hematologic Oncology
• Cellular Therapy
• Patient-Reported Outcomes Research

Background:

• Chimeric antigen receptor T-cell (CAR-T) therapy offers a significant advancement for relapsed/refractory hematologic malignancies.
• CAR-T therapy is associated with substantial toxicities, impacting patient outcomes.
• The predictive value of pre-treatment patient-reported outcomes (PROs) for CAR-T therapy results is not well-established.

Purpose of the Study:

• To investigate the association between pre-CAR-T infusion PROs and clinical outcomes.
• To analyze the impact of Quality of Life (QOL), physical symptoms, anxiety, and depression on CAR-T related toxicities and survival.

Main Methods:

• Secondary analysis of a longitudinal study involving 100 adult patients undergoing CAR-T therapy.
• Pre-CAR-T assessment of QOL, mood, and physical symptoms using validated questionnaires.
• Statistical analysis using univariate and multivariable models to correlate PROs with cytokine release syndrome (CRS), neurotoxicity, length of stay (LOS), and overall survival (OS).

Main Results:

• Higher pre-CAR-T QOL correlated with reduced risk of CRS and neurotoxicity.
• Increased pre-CAR-T depression symptoms were associated with a higher risk of neurotoxicity.
• Worse pre-CAR-T physical symptoms predicted poorer overall survival (OS).
• No significant association was found between pre-CAR-T PROs and LOS.

Conclusions:

• Pre-CAR-T PROs, including QOL and symptom burden, are significant predictors of CAR-T therapy outcomes.
• PROs can serve as valuable prognostic factors for patients undergoing CAR-T treatment.
• Incorporating PROs into pre-treatment assessments may enhance patient management and outcome prediction in CAR-T therapy.