CAR-T 细胞治疗对加拿大弥漫大 B 细胞淋巴瘤患者健康效用的影响

Chimeric antigen receptor T-cell (CAR T) therapy has been shown to improve survival for patients with diffuse large B-cell lymphoma (DLBCL), but it comes at a high cost. Few studies have assessed the impact of CAR T on the health utilities of patients outside clinical trials. This information is important for economic evaluations aimed at determining the value for money of CAR T therapy and for guiding patient care decisions. This objective of this study was to evaluate the impact of CAR T-cell therapy on the health utilities of patients diagnosed with relapsed/refractory (r/r) DLBCL.

A prospective, longitudinal study was conducted at Princess Margaret Cancer Centre (Toronto) from April 2022 to March 2023. Patients were assessed at baseline, 2 wk, 3 mo, and 6 mo post-treatment. Patients completed the EQ-5D-5L and EQ-5D-5L visual analog scale (VAS), the EORTC QLQ-C30, and a clinical data form.

Using a Canadian valuation algorithm and population weights, the EQ-5D-5L and EORTC QLQ-C30 were converted to utility values. The EORTC QLQ C-30 was converted to the Quality-of-Life Utility-Core 10 dimensions (QLU-C10D). Descriptive analyses were conducted for each assessment, the mean utility scores and mean change from baseline were calculated.

We used weighted generalized estimating equations to examine the predictors of health utility values. A total of 55 patients were treated with CAR T (mean age 58 yr, 55% male). The baseline scores were 0. 82 0. 12 (EQ-5D-5L), 0. 67 0. 23 (QLU-C10D), and 74 17 (VAS). The mean change from baseline and 2 wk post-treatment was -0. 044, -0. 163, and -8. 54, respectively. From baseline to 6 mo post-treatment, the change was -0. 053, -0. 002, and 3. 3, respectively. Progression status was a significant predictor of utility scores across all instruments.