“We found that patients who are more heavily treated didn’t have a harder quality of life overall,” an expert told CURE®.
Having a one-time treatment like Carvykti (ciltacabtagene autoleucek; cilta-cel) that offers a long period without maintenance therapy is a “big deal” for patients with pretreated multiple myeloma, explained Samantha Gagnon, a clinical research nurse at Moffitt Cancer Center.
Earlier this month, the Food and Drug Administration for patients with relapsed or refractory myeloma that is refractory to Revlimid (lenalidomide) and previously received a proteasome inhibitor and an immunomodulatory drug.
“These patients who are currently receiving [Carvykti] under the FDA guidelines are pretty heavily pretreated and might not have as many options moving forward — though they still have options, of course,” Gagnon said in an interview with CURE®. “We’ve seen patients who are sometimes on their eighth or ninth line of therapy now are able to have access to Carvykti. We saw really great results with it in clinical trials.”
Carvykti is a CAR-T cell therapy that works by extracting patients’ T cells and reengineering them to find and fight cancer. The cells are then multiplied outside of the body and then reinfused.
Side Effect Monitoring After Carvykti Treatment
After receiving Carvykti, patients are closely monitored for side effects — namely neurotoxicity and cytokine release syndrome — for about a month, Gagnon said.
The period after CAR-T cell therapy is “similar to the transplant process … where you need to stay in a bit of a bubble for a while [and not go too far from the treatment center]” Gagnon said. “Once that acute period of about 30 days is over, patients will still be coming in for frequent lab draws and seeing their provider to manage any symptoms and side effects, but overall, they can ease back into their normal life.”
As patients with myeloma go back to their lives after CAR-T cell therapy — and perhaps an extended period when they do not need any treatment — it is important that they know what kind of side effects and late effects to look out for.
“When patients get a CAR-T product, they get a very extensive education on calling [their health care team] at the first sign of anything unusual that comes in,” Gagnon said. “They get a little wallet card that they take with them and are supposed to be carrying around no matter what. So even if they end up at an emergency room or somewhere where they’re not treated, they can say, ‘I had this treatment. There are a lot of specific guidelines to keep me safe because there are new cells running through my body trying to fight off myeloma.’”
Longer-Term Quality of Life After CAR-T Cell Therapy
Neurotoxicity and cytokine release syndrome typically happen in the acute phase soon after CAR-T cell infusion, but there was not much research into how patients feel long-term on these therapies, according to Gagnon.
So, last year, she and colleagues researched the health-related quality of life two or more months after patients received CAR-T cell therapy.
“We found that patients who are more heavily treated didn’t have a harder quality of life overall. We saw really amazing results in the quality of life, and it was all self-reported,” Gagnon said. “We looked at age, sex, race, ethnicity and prior lines of therapy and we were pleasantly surprised that there wasn’t a ton of difference [in quality of life] between those cutoffs.”
Gagnon mentioned that the experience for one person who received Carvykti or another CAR-T cell therapy may not be the same for the next. However, having this patient-reported data could help patients decide if this is the right therapy for them.
“We don’t want to give false hope to somebody or say that this is definitely what’s going to happen or how you’re going to react,” Gagnon said. “But there is some information where there wasn’t any before, and that’s a really scary thing to go into. The treatment is intimidating. … So it really gives us the opportunity to tell those future patients [about what others experienced].”