“Waitlist mortality” is high for myeloma patients with limited access to BCMA therapy
BackgroundThe first-in-class approved BCMA CAR-T therapy was idecabtagene vicleucel (ide-cel), approved in March 2021, for RRMM patients who progressed after 4 or more lines of therapy. Despite the promising outcomes, there were limited apheresis/production slots for ide-cel. We report outcomes of p...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-08-01
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| Series: | Frontiers in Oncology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2023.1206715/full |
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| author | Nausheen Ahmed William Wesson Muhammad Umair Mushtaq Rajat Bansal Haitham AbdelHakim Sarah Bromert Allison Appenfeller Batool Abu Ghazal Anurag Singh Sunil Abhyankar Siddhartha Ganguly Siddhartha Ganguly Joseph McGuirk Al-Ola Abdallah Leyla Shune |
| author_facet | Nausheen Ahmed William Wesson Muhammad Umair Mushtaq Rajat Bansal Haitham AbdelHakim Sarah Bromert Allison Appenfeller Batool Abu Ghazal Anurag Singh Sunil Abhyankar Siddhartha Ganguly Siddhartha Ganguly Joseph McGuirk Al-Ola Abdallah Leyla Shune |
| author_sort | Nausheen Ahmed |
| collection | DOAJ |
| description | BackgroundThe first-in-class approved BCMA CAR-T therapy was idecabtagene vicleucel (ide-cel), approved in March 2021, for RRMM patients who progressed after 4 or more lines of therapy. Despite the promising outcomes, there were limited apheresis/production slots for ide-cel. We report outcomes of patients at our institution who were on the “waitlist” to receive ide-cel in 2021 and who could not secure a slot.MethodsWe conducted a retrospective review of RRMM patients evaluated at the University of Kansas Cancer Center for ide-cel from 3/2021-7/2021. A retrospective chart review was performed to determine patient and disease characteristics. Descriptive statistics were reported using medians for continuous variables. Survival analysis from initial consult was performed using Kaplan-Meier Survival estimator.ResultsForty patients were eligible and were on the “waitlist” for CAR-T. The median follow-up was 14 months (2-25mo). Twenty-four patients (60%) secured a production slot and 16 (40%) did not. The median time from consult to collection was 38 days (8-703). The median time from collection to infusion was 42 days (34-132 days). The median overall survival was higher in the CAR-T group (NR vs 9 mo, p<0.001).Conclusion(s)Many patients who were eligible for ide-cel were not able to secure a timely slot in 2021. Mortality was higher in this group, due to a lack of comparable alternatives. Increasing alternate options as well as improvement in manufacturing and access is an area of high importance to improve RRMM outcomes. |
| first_indexed | 2024-03-12T17:42:25Z |
| format | Article |
| id | doaj.art-2b8971cfcaa84a3c9175b572237e8814 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-03-12T17:42:25Z |
| publishDate | 2023-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-2b8971cfcaa84a3c9175b572237e88142023-08-04T01:35:50ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2023-08-011310.3389/fonc.2023.12067151206715“Waitlist mortality” is high for myeloma patients with limited access to BCMA therapyNausheen Ahmed0William Wesson1Muhammad Umair Mushtaq2Rajat Bansal3Haitham AbdelHakim4Sarah Bromert5Allison Appenfeller6Batool Abu Ghazal7Anurag Singh8Sunil Abhyankar9Siddhartha Ganguly10Siddhartha Ganguly11Joseph McGuirk12Al-Ola Abdallah13Leyla Shune14Division of Hematologic Malignancies & Cellular Therapeutics, University of Kansas Cancer Center, Westwood, KS, United StatesSchool of Medicine, University of Kansas, Kansas, KS, United StatesDivision of Hematologic Malignancies & Cellular Therapeutics, University of Kansas Cancer Center, Westwood, KS, United StatesDivision of Hematologic Malignancies & Cellular Therapeutics, University of Kansas Cancer Center, Westwood, KS, United StatesDivision of Hematologic Malignancies & Cellular Therapeutics, University of Kansas Cancer Center, Westwood, KS, United StatesDivision of Hematologic Malignancies & Cellular Therapeutics, University of Kansas Cancer Center, Westwood, KS, United StatesDivision of Hematologic Malignancies & Cellular Therapeutics, University of Kansas Cancer Center, Westwood, KS, United StatesDivision of Hematologic Malignancies & Cellular Therapeutics, University of Kansas Cancer Center, Westwood, KS, United StatesDivision of Hematologic Malignancies & Cellular Therapeutics, University of Kansas Cancer Center, Westwood, KS, United StatesDivision of Hematologic Malignancies & Cellular Therapeutics, University of Kansas Cancer Center, Westwood, KS, United StatesDivision of Hematologic Malignancies & Cellular Therapeutics, University of Kansas Cancer Center, Westwood, KS, United StatesMary and Ron Neal Cancer Center, Houston Methodist Hospital, Houston, TX, United StatesDivision of Hematologic Malignancies & Cellular Therapeutics, University of Kansas Cancer Center, Westwood, KS, United StatesDivision of Hematologic Malignancies & Cellular Therapeutics, University of Kansas Cancer Center, Westwood, KS, United StatesDivision of Hematologic Malignancies & Cellular Therapeutics, University of Kansas Cancer Center, Westwood, KS, United StatesBackgroundThe first-in-class approved BCMA CAR-T therapy was idecabtagene vicleucel (ide-cel), approved in March 2021, for RRMM patients who progressed after 4 or more lines of therapy. Despite the promising outcomes, there were limited apheresis/production slots for ide-cel. We report outcomes of patients at our institution who were on the “waitlist” to receive ide-cel in 2021 and who could not secure a slot.MethodsWe conducted a retrospective review of RRMM patients evaluated at the University of Kansas Cancer Center for ide-cel from 3/2021-7/2021. A retrospective chart review was performed to determine patient and disease characteristics. Descriptive statistics were reported using medians for continuous variables. Survival analysis from initial consult was performed using Kaplan-Meier Survival estimator.ResultsForty patients were eligible and were on the “waitlist” for CAR-T. The median follow-up was 14 months (2-25mo). Twenty-four patients (60%) secured a production slot and 16 (40%) did not. The median time from consult to collection was 38 days (8-703). The median time from collection to infusion was 42 days (34-132 days). The median overall survival was higher in the CAR-T group (NR vs 9 mo, p<0.001).Conclusion(s)Many patients who were eligible for ide-cel were not able to secure a timely slot in 2021. Mortality was higher in this group, due to a lack of comparable alternatives. Increasing alternate options as well as improvement in manufacturing and access is an area of high importance to improve RRMM outcomes.https://www.frontiersin.org/articles/10.3389/fonc.2023.1206715/fullBCMAide-celaccessproduction slotwaitlistmyeloma |
| spellingShingle | Nausheen Ahmed William Wesson Muhammad Umair Mushtaq Rajat Bansal Haitham AbdelHakim Sarah Bromert Allison Appenfeller Batool Abu Ghazal Anurag Singh Sunil Abhyankar Siddhartha Ganguly Siddhartha Ganguly Joseph McGuirk Al-Ola Abdallah Leyla Shune “Waitlist mortality” is high for myeloma patients with limited access to BCMA therapy Frontiers in Oncology BCMA ide-cel access production slot waitlist myeloma |
| title | “Waitlist mortality” is high for myeloma patients with limited access to BCMA therapy |
| title_full | “Waitlist mortality” is high for myeloma patients with limited access to BCMA therapy |
| title_fullStr | “Waitlist mortality” is high for myeloma patients with limited access to BCMA therapy |
| title_full_unstemmed | “Waitlist mortality” is high for myeloma patients with limited access to BCMA therapy |
| title_short | “Waitlist mortality” is high for myeloma patients with limited access to BCMA therapy |
| title_sort | waitlist mortality is high for myeloma patients with limited access to bcma therapy |
| topic | BCMA ide-cel access production slot waitlist myeloma |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2023.1206715/full |
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