Patient-reported outcomes after idecabtagene vicleucel vs. ciltacabtagene autoleucel CAR-T for multiple myeloma

This was the first study to assess patient-reported outcome (PRO) trajectories among patients with relapsed/refractory multiple myeloma (RRMM) receiving standard of care chimeric antigen receptor T-cell therapy (CAR-T) and to compare PRO trajectories by treatment group, idecabtagene vicleucel (ide-cel) vs. ciltacabtagene autoleucel (cilta-cel). Participants completed health-related quality of life (HRQOL) and symptom surveys at enrollment/baseline (pre-lymphodepletion), infusion day(D)0, D7, D14, D21, D30, D60, and D90. Piecewise growth curve models assessed PRO trajectories pre-D7 and post-D7. Among 99 participants, ide-cel recipients (n = 49) were older than cilta-cel recipients (n = 50) (median 73 vs. 64 years, p < 0.001). Many PROs worsened pre-D7 and improved post-D7, including overall HRQOL, physical well-being, functional well-being, fatigue, physical function, and social function (p-values < 0.05). Several PROs were stable pre-D7 and improved post-D7, including anxiety, sleep disturbance, pain interference, and pain intensity (p-values < 0.05). There were differences between groups in the trajectories of social well-being pre-D7 (p = 0.01) and cognitive function post-D7 (p = 0.001). Patients with RRMM receiving standard of care CAR-T had similar PRO trajectories regardless of CAR-T type, with most PROs initially worsening or stable before significantly improving post-treatment. Future studies should investigate potential differences by treatment for social well-being and cognitive function as well as PRO trajectories beyond D90 post-treatment.