Quality of life in caregivers of patients receiving chimeric antigen receptor T‐cell therapy

Barata, Anna; Hoogland, Aasha I.; Hyland, Kelly A.; Otto, Amy K.; Kommalapati, Anuhya; Jayani, Reena; Irizarry-Arroyo, Nathaly; Collier, Aaron; Rodriguez, Yvelise; Welniak, Taylor; Booth-Jones, Margaret; Logue, Jennifer M.; Small, Brent J.; Jain, Michael D.; Reblin, Maija; Locke, Frederick L.; Jim, Heather

doi:10.1002/pon.5674

Cited by 10 publications

(7 citation statements)

References 33 publications

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“…Also, we did not evaluate the quality of PRO assessment methodology and outcome reporting and future research should focus on this important aspect. Although beyond the scope of our review, the HRQoL of caregivers of patients treated with CAR T‐cell therapy may also be affected and this is a valuable area for further investigation 90 …”

Section: Discussionmentioning

confidence: 99%

Chimeric Antigen Receptor T-cell Therapy in Hematologic Malignancies and Patient-reported Outcomes: A Scoping Review

et al. 2022

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The inclusion of patient-reported outcome (PRO) measures in chimeric antigen receptor (CAR) T-cell therapy research is critical for understanding the impact of this novel approach from a unique patient standpoint. We performed a scoping review to map the available literature on the use of PRO measures in CAR T-cell therapy studies of patients with hematologic malignancies published between January 2015 and July 2022. Fourteen studies were identified, of which 7 (50%) were investigational early-phase trials, 6 (42.9%) were observational studies, and 1 (7.1%) was a pilot study. The EQ-5D and the PROMIS-29 were the 2 most frequently used PRO measures, being included in 6 (42.9%) and 5 (35.7%) studies, respectively. Despite differences in study designs, there seems to be evidence of improvements over time since CAR T-cell infusion in important domains such as physical functioning and fatigue, at least in patients who respond to therapy. Overall, the studies identified in our review have shown the added value of PRO assessment in CAR T-cell therapy research by providing novel information that complements the knowledge on safety and efficacy. However, there are several questions which remain to be answered in future research. For example, limited evidence exists regarding patient experience during important phases of the disease trajectory as only 4 (28.6%) and 5 (35.7%) studies provided information on PROs during the first 2 weeks from CAR T-cell infusion and after the first year, respectively. Time is ripe for a more systematic implementation of high-quality PRO assessment in future clinical trials and in real-life settings of patients treated with CAR T-cell therapy.

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Section: Discussionmentioning

confidence: 99%

Chimeric Antigen Receptor T-cell Therapy in Hematologic Malignancies and Patient-reported Outcomes: A Scoping Review

et al. 2022

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“…Caregiver involvement has been associated with lower patient distress and even improved patient survival (164)(165)(166). Caregiver distress is also associated with poorer patient response to treatment (167), and caregiver well-being is associated with better patient QOL (168). Therefore, the biological and psychological effects of pandemic-related stress for caregivers has the potential to translate to downstream adverse TCT patient outcomes (167,(169)(170)(171)(172)(173).…”

Section: Caregiversmentioning

confidence: 99%

“…Caregiver distress is also associated with poorer patient response to treatment (167), and caregiver well-being is associated with better patient QOL (168). Therefore, the biological and psychological effects of pandemic-related stress for caregivers has the potential to translate to downstream adverse TCT patient outcomes (167,(169)(170)(171)(172)(173). The Covid-19 pandemic undoubtedly imposes additional stress on TCT caregivers; however, little research has directly explored this (174)(175)(176).…”

Section: Caregiversmentioning

confidence: 99%

Biobehavioral Implications of Covid-19 for Transplantation and Cellular Therapy Recipients

Knight¹,

Taylor²,

Rentscher³

et al. 2022

Front. Immunol.

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A growing body of literature has emphasized the importance of biobehavioral processes – defined as the interaction of behavior, psychology, socioenvironmental factors, and biological processes – for clinical outcomes among transplantation and cellular therapy (TCT) patients. TCT recipients are especially vulnerable to distress associated with pandemic conditions and represent a notably immunocompromised group at greater risk for SARS-CoV-2 infection with substantially worse outcomes. The summation of both the immunologic and psychologic vulnerability of TCT patients renders them particularly susceptible to adverse biobehavioral sequelae associated with the Covid-19 pandemic. Stress and adverse psychosocial factors alter neural and endocrine pathways through sympathetic nervous system and hypothalamic-pituitary-adrenal axis signaling that ultimately affect gene regulation in immune cells. Reciprocally, global inflammation and immune dysregulation related to TCT contribute to dysregulation of neuroendocrine and central nervous system function, resulting in the symptom profile of depression, fatigue, sleep disturbance, and cognitive dysfunction. In this article, we draw upon literature on immunology, psychology, neuroscience, hematology and oncology, Covid-19 pathophysiology, and TCT processes to discuss how they may intersect to influence TCT outcomes, with the goal of providing an overview of the significance of biobehavioral factors in understanding the relationship between Covid-19 and TCT, now and for the future. We discuss the roles of depression, anxiety, fatigue, sleep, social isolation and loneliness, and neurocognitive impairment, as well as specific implications for sub-populations of interest, including pediatrics, caregivers, and TCT donors. Finally, we address protective psychological processes that may optimize biobehavioral outcomes affected by Covid-19.

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“…This population provides essential support for patients receiving ACT and may endure significant distress and have a decreased quality of life, increased depression and post-traumatic stress symptoms. 10 Future research is needed on how to better support caregivers during ACT and to identify unmet caregiver needs.…”

Section: Recommendation To Address Gapsmentioning

confidence: 99%

Patient-reported outcomes in adoptive cell-therapy trials: mind the gap

Ghisoni

Morotti

Colomer‐Lahiguera

et al. 2022

J Immunother Cancer

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Adoptive cell therapies (ACT) have demonstrated promise in the treatment of patients with cancer, leading to long-lasting responses and, in some cases, even cure. Technological advances have brought these individualized therapies closer to reality, establishing them as credible therapeutic option. However, to date, few efforts have been made to understand patients' experience during ACT trials. Patient-reported outcomes (PROs) and patient-reported outcome measures (PROMs), which are instruments used to report PROs, are increasingly being used in oncology to capture patients’ perspective, provide real-world data on treatment safety, and support decision-making processes, such as health economic decisions. Due to the inherent complexity of ACT, the inclusion of PROMs in this field remains limited. In this commentary, we discuss the benefit of capturing PROs in ACT trials, the challenges of PROM administration and collection, and we propose simple and actionable recommendations to promote their adoption in ACT trials.

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Quality of life in caregivers of patients receiving chimeric antigen receptor T‐cell therapy

Cited by 10 publications

References 33 publications

Chimeric Antigen Receptor T-cell Therapy in Hematologic Malignancies and Patient-reported Outcomes: A Scoping Review

Chimeric Antigen Receptor T-cell Therapy in Hematologic Malignancies and Patient-reported Outcomes: A Scoping Review

Biobehavioral Implications of Covid-19 for Transplantation and Cellular Therapy Recipients

Patient-reported outcomes in adoptive cell-therapy trials: mind the gap

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