Adult patients with diffuse large B-cell lymphoma (DLBCL) whose disease was effectively treated with the chimeric antigen receptor (CAR) T-cell therapy tisagenlecleucel showed sustained and clinically meaningful improvement in a variety of self-reported quality-of-life measures, according to research findings reported by Maziarz et al in the journal Blood Advances.
Prior to the advent of CAR T-cell therapy and other forms of cellular immunotherapy, patients with DLBCL had limited treatment options—and patients with advanced DLBCL had often already exhausted those options. CAR T-cell therapies have demonstrated sustained clinical remissions and better survival rates in some of these patients vs traditional therapies.
Reporting Quality of Life
Aiming to identify additional patient benefits of CAR T-cell therapy, researchers evaluated quality of life in adult patients with relapsed or refractory DLBCL undergoing treatment with tisagenlecleucel in the phase II JULIET trial. Patients were asked to report on their quality of life using two tools, the Functional Assessment of Cancer Therapy-Lymphoma (FACT-Lym) and Short Form-36 (SF-36) Health Survey: one assessed physical, social, emotional, and functional well-being, as well as disease- and treatment-related symptoms; while the other elicited responses relating to physical and social function, health perception, and mental health. Data were collected prior to treatment and then again at months 3, 6, 12, and 18 following treatment, unless the patients discontinued participation in the study or their disease progressed.
KEY POINTS
- Baseline scores on patient-reported quality-of-life outcomes were similar between the total patient population and those who responded to the therapy, but responsive patients demonstrated continued improvement in quality-of-life measures over time.
- Compared to baseline, their most significant improvements were in areas of general health, vitality, physical function, and social function.
Findings
Out of 108 evaluated patients, 57 achieved a complete or partial response to tisagenlecleucel treatment. Baseline scores on patient-reported quality-of-life outcomes were similar between the total patient population and those who responded to the therapy, but responsive patients demonstrated continued improvement in quality-of-life measures over time. Compared to baseline, their most significant improvements were in areas of general health, vitality, physical function, and social function.
“Many patients with this advanced level of disease become depressed and withdrawn, but here, patients reported improved functional status, physical capabilities, and ability to interact with people,” said lead study author Richard Maziarz, MD, of Oregon Health & Science University School of Medicine. “As we progress in our capacity to offer therapies to treat cancers, we have to ask: is it enough to just have our patients in remission or alive, or do we want them to be able to truly live again, and to reenter society with full function?”
Disclosure: This study was supported by Novartis. For full disclosures of the study authors, visit ashpublications.org.
