“Waitlist mortality” is high for myeloma patients with limited access to BCMA therapy

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

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

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). 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.

Original languageEnglish (US)
Article number1206715
JournalFrontiers in Oncology
Volume13
DOIs
StatePublished - 2023

Keywords

  • access
  • BCMA
  • ide-cel
  • myeloma
  • production slot
  • waitlist

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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