An Assessment: Side-Effect Incidence for Those Treated with CAR-T vs. Other Treatments in the Relapsing/ Refractory Disease
Authors:
M. Butcharts, S. Kaingage, S. Alexander, A. Watson, L. Warwick
Lymphoma Coalition, Mississauga, Canada
Background
Lymphoma Coalition (LC) supports over 90 member organizations across 54 countries. LC’s overarching vision is equity in lymphoma outcomes across borders.
In the setting of relapsed/refractory lymphoma, patients will have experienced at least one line of therapy and will likely be facing another to prolong life. CAR-T is gaining traction as a novel approach to treat relapsed/refractory disease. Due to the novelty of CAR-T use, a knowledge gap exists regarding some of the rarer side-effects associated with CAR-T.
We sought to address this in a sample of patients with:
- Mantle Cell
- Hodgkin
- Transformed Follicular
- DLBCL
Methods
The Global Patient Survey (GPS) was deployed to lymphoma patients via members of the Lymphoma Coalition network in 2022. Patients who indicated they were receiving CAR-T and had relapsed at least once were selected for inclusion.
Contingent analysis was used to explore whether any of 32 patient-reported side-effects were enhanced in those receiving CAR-T compared to those who have received other treatments.
The cohort was composed of 664 patients, with 11% (N=60) receiving CAR-T. Median age of respondents was 51 years for those who received CAR-T vs. other treatments respectively (p=0.092).
DLBCL comprised 40% of the cohort with Hodgkin, Mantle Cell and Follicular comprising 35%, 17% and 8% respectively. CAR-T represented a higher proportion of treatment histories in DLBCL (21%) than in Hodgkin (3%) (p<0.001).
Significant increases in side-effect incidence in the CAR-T subset included:
- Sexual/intimacy problems
- Anemia
- Diarrhea
- Hair loss
- Eyesight issues
- Neutropenia
Borderline significance was reported for loss of memory (p=0.07).
Results
Demographics of Lymphoma Patients Who Received CAR-T
- DLBCL Unspecified (N=21): 29.1%
- DLBCL GCB (N=12): 23.8%
- DLBCL ABC (N=27): 25.5%
- Transformed Follicular (N=15): 2.3%
- Hodgkin (N=158): 9.3%
- Mantle Cell (N=64): 9.8%
Figures
(Figures compare side-effect incidence between CAR-T and non–CAR-T patients. Reported p-values indicate statistical significance.)
- Figure 1: Sexual/intimacy problems (p=0.0001)
- Figure 2: Anemia (p=0.0001)
- Figure 3: Diarrhea (p=0.0034)
- Figure 4: Hair loss (p=0.0188)
- Figure 5: Eyesight issues (p=0.0345)
- Figure 6: Neutropenia (p=0.0396)
Conclusion
This analysis expands knowledge of the mosaic of side effects experienced by those receiving CAR-T therapy.
CAR-T therapy is typically reported in terms of severe acute toxicities; this report highlighted increased incidence of chronic toxicities for patients who have received CAR-T.
These findings advocate for further research and collection of additional data.
Disclosure
The study was sponsored by AbbVie, BMS, Genmab, Incyte, Roche. None of the authors benefited personally from the research.
Acknowledgements
For further details on the LC 2022 GPS, please scan the QR code or visit:
👉 https://lymphomacoalition.org/global-patient-survey
Please direct any queries to the research department at Lymphoma Coalition:
📧 steve@lymphomacoalition.org
Summary
The Lymphoma Coalition analyzed side-effect incidence in patients with relapsed/refractory lymphoma who received CAR-T therapy compared with other treatments, using data from the 2022 Global Patient Survey.
- Cohort: 664 patients; 11% received CAR-T.
- Demographics: CAR-T was most common in DLBCL (21%), less so in Hodgkin (3%). Median age: 51 years.
Key Findings
Patients receiving CAR-T reported significantly higher rates of:
- Sexual/intimacy problems
- Anemia
- Diarrhea
- Hair loss
- Eyesight issues
- Neutropenia
There was also a borderline increase in memory loss.
Conclusion
CAR-T patients experience an expanded set of chronic side effects beyond the acute toxicities usually reported. These results highlight the need for further research and better long-term monitoring of CAR-T recipients.
Disclosure
The study was sponsored by AbbVie, BMS, Genmab, Incyte, and Roche. Authors reported no personal benefit.