Patients referred for chimeric antigen receptor (CAR) T-cell therapy had an overly optimistic perception of their disease prognosis and high rates of psychological distress, according to a study published in Cancer.
“Patient’s perception of their prognosis is essential for medical decision‐making, especially in the context of uncertainty,” study researchers explained. “Although CAR T‐cell therapy is potentially curative, treatment may coincide with life‐threatening toxicities. … Furthermore, nearly half of all patients receiving CAR T‐cell therapy experience disease progression.”
The researchers conducted a cross-sectional study of 102 patients receiving CAR T-cell therapy for a hematologic malignancy and assessed quality of life, anxiety, and depression symptoms as well as prognostic awareness.
Of the 102 patients enrolled, about one-third (34%) reported being told by their oncologist that their cancer is curable. About two-thirds (64%) reported being told that there was a greater than 50% change of cure.
Results indicated that a substantial minority of patients receiving CAR T cell therapy experienced clinically significant psychological distress, the researchers wrote. Clinically significant depression was reported in 26% of patients, anxiety in 30%, and posttraumatic stress disorder in 21%.
There was no association identified between a patients’ understanding of prognosis and quality of life or mood. However, higher emotional coping with prognosis was linked to better quality of life (P<.001) and low depression (P<.001), anxiety (P<.001), and PTSD (P<.001) symptoms.
Additionally, higher adaptive response—the ability to use prognostic awareness to inform life decisions—was associated with better quality of life (P=.028) and lower depression (P=.023), anxiety (P=<.001), and PTSD (P<.001) symptoms.
“These findings underscore the need for interventions that enhance CAR‐T patients’ prognostic understanding and effective coping to improve QOL and alleviate psychological distress in this patient population,” concluded the researchers.