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ASH 2024 | Assessing financial toxicity of CAR-T therapy in myeloma and improving access to this treatment
Doris Hansen, MD, Moffitt Cancer Center, Tampa, FL, comments on the topic of the financial toxicity of CAR T-cell therapy for patients with multiple myeloma (MM), highlighting that while the treatment may be perceived as expensive, its long-term benefits and potential for durable responses outweigh the costs. Dr Hansen notes that a cost-per-responder model analysis showed a significant financial benefit to ciltacabtagene autoleucel (cilta-cel) CAR-T therapy compared to standard of care and emphasizes the need for solutions to improve access to reduce the amount of time patients spend off work. This interview took place at the 66th ASH Annual Meeting and Exposition, held in San Diego, CA.
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Transcript (AI-generated)
This is a difficult question. There are many parts to it. I do think that there is a perception that CAR T-cell therapy may be more expensive than standard-of-care options, but I think what needs to be made clear is that in patients receiving CAR T-cell therapy, in theory, this is a one-and-done type of treatment that offers a long disease-free period. The median PFS for cilta-cel is about 35 months in the CARTITUDE-2 study...
This is a difficult question. There are many parts to it. I do think that there is a perception that CAR T-cell therapy may be more expensive than standard-of-care options, but I think what needs to be made clear is that in patients receiving CAR T-cell therapy, in theory, this is a one-and-done type of treatment that offers a long disease-free period. The median PFS for cilta-cel is about 35 months in the CARTITUDE-2 study. So I mean, you’re three years treatment-free, and particularly in patients who have a complete response or a really deep response right away, they’re likely going to have more durable responses down the road. We have done a cost-per-responder model analysis, which was recently published, where we compared the cost of patients receiving cilta-cel versus those receiving standard of care. And we actually saw a significant benefit in terms of financial benefit to receiving CAR-T compared to standard of care.
Certainly access, I think to me, is a very big issue and one of the bigger issues because patients have to have a caregiver. They have to have the means to go to an academic center or to a site that provides CAR-T. They have to have a caregiver and that may limit the amount of time that they’re away from work, that they’re getting paid. So I think that’s a bigger issue and certainly, we need more solutions to this, but as CAR-T perhaps becomes more widely available beyond certain academic centers, that may help with some of this burden. We are looking at some data, with an ongoing study looking at social determinants of health, and hopefully, identifying some other indices or predictors for how we can improve access for certain patient populations.
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Disclosures
Research funding: Bristol Myers Squibb/Celgene, Janssen, Adaptive Biotechnologies, Kite Pharma, Karyopharm; Additional funding from Pentecost Myeloma Research Center, Myers Foundation, Schulze and M-CARES awards (pilot grants) via Moffitt Cancer Center; Consultancy: Bristol Myers Squibb, Janssen, Legend Biotech, Karyopharm, Kite Pharma, AstraZeneca, Pfizer.
