|The following article features coverage from the American Society of Hematology 2019 meeting. Click here to read more of Cancer Therapy Advisor‘s conference coverage.|
According to “real-world” evidence presented at the 61st American Society of Hematology (ASH) Annual Meeting and Exposition held in Orlando, Florida, of adult patients with relapsed/refractory diffuse large B-cell lymphoma (DLBCL) who received CD19-directed chimeric antigen receptor T-cell (CAR-T) therapy, post–CAR-T therapy health care costs were lower than those incurred prior to CAR-T cell therapy.
Two CD19-directed CAR-T therapies (ie, axicabtagene ciloleucel; tisagenlecleucel) received approval from the US Food and Drug Administration (FDA) in 2017 for the treatment of adults with relapsed/refractory DLBCL who had received at least 2 prior systemic therapies.
This study accessed claims data from the Center for Medicare and Medicaid Services (CMS) 100% Medicare Fee-for-Service (FFS) Parts A and B in order to evaluate the pre–CAR-T and post–CAR-T health care utilization and costs for adult patients with DLBCL who received CAR-T therapy between 10/1/2017 and 9/30/2018. All patients included in the study were continuously enrolled in FFS for 6 months prior to the CAR-T therapy infusion index date and at least 6 months following administration of CAR-T therapy or death.
Of the 207 patients included in the study, 59.9% were men and 87.4% were classified as being of white race. Approximately 92% of patients had a diagnosis of DLBCL, with disease classified as “other Non-Hodgkin lymphoma” in the remaining 8% of patients. Nearly 90% of the patients included in the study, were enrolled in Medicare based on age, not disability (median age, 70.1 years).
Other baseline patient characteristics included a Charlson Comorbidity Index score of 3 or higher in approximately three-quarters of patients.
The study presenter Karl M. Kilgore, PhD, of Avalere Health, Bowie, Maryland, noted that at least half of the patients enrolled in this study were likely to have conditions that would have excluded them from receiving CAR-T therapy in a clinical trial.
At a median follow-up of 12 months, 6-month overall survival (OS) was 72.9%, and median OS had not yet been reached.
Administration of CAR-T therapy was associated with a median length of hospital stay of 17 days, and included admission to the intensive care unit, and a corresponding increase in median length of hospital stay of 13 days, for only approximately one-half of the patients.
A key study finding was that the rates of hospitalization and emergency department visits decreased by 17.4% and 45% when the pre-index period was compared with the post-index period, respectively.
Furthermore, a similar comparison of overall health care costs showed a 39% decrease after CAR-T therapy, exclusive of the costs directly associated with the CAR-T procedure.
In his concluding remarks, Dr Kilgore noted that the results of this real-world study indicate that “older patients with multiple comorbidities can be treated successfully with CAR-T therapy, and post-index care was associated with less time in the hospital, fewer emergency department visits, and lower total costs.”
Disclosure: Some of the authors disclosed research funding from Kite Pharma. For a full list of disclosures, please refer to the original study abstract.
Read more of Cancer Therapy Advisor‘s coverage of ASH’s annual meeting by visiting the conference page.
Kilgore KM, Mohammadi I, Schroeder A, et al. Medicare patients receiving chimeric antigen receptor T-cell therapy for non-Hodgkin lymphoma: A first real-world look at patient characteristics, healthcare utilization and costs. Presented at: 61st American Society of Hematology (ASH) Annual Meeting and Exposition; December 7-10, 2019; Orlando, FL. Abstract 793.