Distance to CAR-T Treatment Center Does Not Impede Delivery

• Published in: European journal of haematology
• Main Authors: Tan, Xiu Xia Sherry, Maltez, Melissa T, Mallick, Ranjeeta, Hamelin, Linda, McDiarmid, Sheryl, Cieniak, Carolina, Granger, Matthew, Bredeson, Christopher, Kennah, Michael, Atkins, Harold L, Kekre, Natasha
• Format: Journal Article
• Language: English
• Published: England 24.10.2024
• Subjects: chimeric antigen receptor T‐cell; cellular immunotherapy; lymphoma
• ISSN: 0902-4441; 1600-0609; 1600-0609
• DOI: 10.1111/ejh.14331

Chimeric antigen receptor T-cell (CAR-T) therapy has demonstrated remarkable efficacy in relapsed or refractory large B cell lymphoma, but real-world evidence is needed to confirm safety and efficacy when facing the unique challenges of a wide geographical catchment area. We reviewed patients treated with commercially available CAR-T at a medium-sized single center in Canada (The Ottawa Hospital) between December 2020 and July 2022 (Canadian implementation started in 2020). Fifty-one patients (59% male, median age 62) traveled a median distance of 655 km (range 3-3659) for treatment. Median time from apheresis to CAR-T infusion was 36 days (range 26-81). With a median follow-up of 383 days (95% CI: 333-480), median progression-free survival (PFS) and overall survival (OS) were 257 days (95% CI: 92-NE) and 422 days (95% CI: 106-NE), respectively. The median PFS for out-of-province patients was 115 days (95% CI: 91-NE) versus 280 days for in-province patients (95% CI: 142-NE), p = 0.12. Multivariate analysis demonstrated that distance from treatment center (p = 0.05) and refractory disease status (p = 0.003) were independently associated with shorter PFS. The time from the last disease progression to CAR-T referral was longer for out-of-province patients, but there was no difference in the time of referral to CAR-T consult, apheresis, or CAR-T infusion between in-province and out-of-province patients. Our results confirm that despite the complexity of CAR-T therapy administration, Ottawa can effectively provide commercial CAR-T therapy in a timely fashion for patients from across the country.