"Waitlist mortality" is high for myeloma patients with limited access to BCMA therapy.

Abstract

Background:

The 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.

Methods:

We 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.

Results:

Forty 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).

Conclusions:

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.

• Authors: Nausheen Ahmed, William Wesson, Muhammad Umair Mushtaq, Rajat Bansal, Haitham AbdelHakim, Sarah Bromert, Allison Appenfeller, Batool Abu Ghazal, Anurag Singh, Sunil Abhyankar, Siddhartha Ganguly, Joseph McGuirk, Al-Ola Abdallah, Leyla Shune
• Journal: Frontiers in oncology (Front Oncol) Vol. 13 Pg. 1206715 ( 2023) ISSN: 2234-943X [Print] Switzerland
• PMID: 37601685 (Publication Type: Journal Article)
• Copyright: Copyright © 2023 Ahmed, Wesson, Mushtaq, Bansal, AbdelHakim, Bromert, Appenfeller, Ghazal, Singh, Abhyankar, Ganguly, McGuirk, Abdallah and Shune.