(Press-News.org) (WASHINGTON, March 30, 2023) – Chimeric antigen receptor T-cell (CAR-T) therapy has transformed cancer treatment, yet relatively few studies have investigated the impact of the therapy on longitudinal patient quality of life – an aspect of care that often suffers from receiving traditional intensive cancer medications, such as chemotherapy. A new study published in Blood Advances demonstrates that some effective cancer treatments do improve quality of life, revealing that patients with blood cancers experienced a significant improvement in their reported well-being six months after receiving CAR T-cell therapy.
CAR-T therapies are developed by harvesting a patient’s own T cells (the immune system’s primary cancer-killing cells), engineering them to target proteins specific to the surface of cancer cells, and reintroducing these modified T cells back into the patient’s immune system to kill the cancer cells.
“CAR-T has revolutionized the treatment of patients with relapsed and refractory blood cancers. But it remains a unique treatment with unique toxicities, including cytokine release syndrome, which is an inflammatory flu-like ailment, as well as neurologic toxicities. And these complications can take a toll on patients,” said Connor Johnson, MD, an oncologist at Massachusetts General Hospital and lead study author. “Given the relatively new development of CAR-T therapy, there are a limited set of studies that have examined patient reported outcomes in those receiving these treatments.”
To conduct this study, investigators enrolled 103patients ages 23-90 with a blood cancer diagnosis from April of 2019 to November of 2021. Of these patients, 71% were diagnosed with lymphoma, 28% with myeloma, and 1% with B-cell acute lymphoblastic leukemia. Patients eligible to receive CAR-T therapy were most commonly administered tisagenlecleucel (34%), lisocabtagene maraleucel (16%), axicabtagene ciloleucel (13%), and idecabtaene vicleucel (12%).
The researchers administered self-reported questionnaires measuring quality of life variables at time intervals including prior to CAR-T cell infusion and one week, one month, three months, and six months after CAR-T cell infusion. Quality of life was measured using a 27-item questionnaire, known as the Functional Assessment of Cancer Therapy-General (FACT-G), which measures quality of life factors using four different subscales (physical, functional, emotional, and social) at all time points. Psychological distress was measured using the Hospital Anxiety and Depression Scale (HADS), which assessed variables designed to measure anxiety and depression symptoms at all time points. Lastly, major depressive symptoms were also measured using the PHQ-9, and post-traumatic stress disorder symptoms were measured using the Post-Traumatic Stress Checklist. Researchers also recorded physical symptoms using the Edmonton Symptom Assessment System, which assessed pain, fatigue, drowsiness, nausea, appetite, dyspnea, insomnia, trouble swallowing, and well-being over 24 hours.
Overall, 76% of patients achieved remission and 33% experienced immune effector cell-associated neurotoxicity syndrome, a common side effect of CAR-T therapy. Of note, 38% of patients did not survive the length of follow up for the study.
Investigators were specifically interested in understanding how CAR T-cell therapy affected patient quality of life. They found that for most individuals, quality of life initially declined in the first week after the administration of CAR T-cell therapy (decreasing from a median baseline of 77.9 to 70.1), a time when treatment related symptoms are typically at their peak, and then significantly increased (to a median of 83.7) by the six-month mark post infusion. Similarly, they found improvements in the physical symptom burden, as well as anxiety symptoms.
While most study participants ultimately experienced an improvement in their quality of life, roughly 20% of patients experienced persistent physical and psychological symptoms, which at times were detrimental to quality of life.
Dr. Johnson explains that it is important to recognize the burden CAR-T therapy brings to some patients to maximize the effectiveness of these therapies and improve care for all individuals living with hematologic malignancies.
“Here we show significant improvements in quality of life among patients with an array of blood cancer diagnoses, receiving a variety of CAR-T products,” said Dr. Johnson. “However, we also identify a distinct subset of patients who have persistent physical and psychological symptom burden, even at the six-month post CAR-T time point. And I hope that these findings lead to additional interventions with a goal of improving the overall quality of life trajectory of all patients.”
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Blood Advances (www.bloodadvances.org) publishes more peer-reviewed hematology research than any other academic journal worldwide and is an online only, open access journal of the American Society of Hematology (ASH), the world’s largest professional society concerned with the causes and treatment of blood disorders.
Blood Advances® is a registered trademark of the American Society of Hematology.
Contact:
Kira Sampson, American Society of Hematology
ksampson@hematology.org; 202-499-1796
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PHILADELPHIA – The American Association for Cancer Research (AACR) will award E. John Wherry, PhD, with the 2023 AACR-Cancer Research Institute (CRI) Lloyd J. Old Award in Cancer Immunology during the AACR Annual Meeting 2023, April 14-19 at the Orange County Convention Center in Orlando, Florida.
Wherry is chair of the Department of Systems Pharmacology and Translational Therapeutics, director of the Institute for Immunology, and founding director of the Immune Health Project in the Perelman School of Medicine at the University of Pennsylvania. He is being honored for ...
LOS ANGELES — A newly published study paves the way for some patients with testicular cancer to avoid chemotherapy and radiation.
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Now, however, the results of a multi-institutional ...
Bratislava, Slovakia, March 21, 2023
BGI Genomics is pleased to announce the launch of COLOTECTTM 1.0 in Slovakia, in collaboration with its local partner, Zentya. Zentya is a Slovak-based healthcare solution provider that is passionate about providing patients with the latest technology in the field of genetic screening, aiming to help identify and facilitate timely treatments of genetic diseases.
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PULLMAN, Wash. — Facebook users were more likely to read fake news about the 2020 U.S. presidential election than users of Twitter and other social media websites, a Washington State University-led analysis found.
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By publishing protocols, SLAS underscores the importance of transparency and rigor ...
COLUMBUS, Ohio – Once adults reach age 65, the threshold age for the onset of Alzheimer’s disease, the extent of their genetic risk may outweigh age as a predictor of whether they will develop the fatal brain disorder, a new study suggests.
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Biyu J. He receives the Vilcek Prize for Creative Promise in Biomedical Science for her leadership in the field of cognitive neuroscience, and for her groundbreaking discoveries on the biological bases of perceptual cognition and subjective experience.
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The European Research Council (ERC) has awarded a prestigious Advanced Grant of EUR 2.5 million ($2.6 million) over 5 years to Professor Bernt-Erik Sæther at the Norwegian University of Science and Technology's (NTNU) Department of Biology.
The money will go to find out how we can save species that are in danger of becoming extinct.
“The aim is to develop rules of thumb to identify what is needed to prevent a species from dying out in an area in the short term. At the same time, we must ensure that a population’s ability to adapt to ...
Statement Highlights:
Primary hypertension—high blood pressure that is not due to an underlying medical condition—occurs in up to 5% of children and adolescents in the U.S. and other countries.
Having high blood pressure as a child often leads to high blood pressure in adulthood, which may increase the likelihood of heart disease and stroke, as well as cause damage to the kidneys, eyes and more.
Some risk factors that increase the chances for high blood pressure in children are modifiable, while others are not.
Regular and appropriate assessment of blood pressure levels in children is important, as there are often no symptoms of high blood pressure.
Public health initiatives ...
ROME, ITALY - Cacao of Excellence is proud to unveil its new state-of-the-art cacao R&D laboratory and training centre. Located at Via Baccio Baldini 4 in Rome, the facility will be dedicated to exploring the depths of cacao quality and sensory analysis and revealing the diversity of cacao flavour profiles.
The laboratory and training centre will accommodate the processing and evaluation of cacao samples received from over 55 participating origins for the global Cacao of Excellence Awards, and will serve as a cacao quality processing and sensory training centre for cacao-producing origins.
Cacao of Excellence’s ...