Survey Defines COVID’s Impact on Delivery of CAR T-Cell Therapy in Europe

A recent letter to Bone Marrow Transplantation describes results of a survey that aimed to capture the impact of the COVID-19 pandemic’s first wave, as well as its associated economic effects, on the delivery of chimeric antigen receptor (CAR) T-cell therapy in Europe. Key findings include:
• Half of centers experienced a decreased capacity for patients due to the pandemic.
• A third of centers reported delays in CAR T-cell therapy delivery.
The survey was administered by the Cellular Therapy and Immunobiology Working Party (CTIWP) of the European Society for Blood and Marrow Transplantation (EBMT). The results were submitted by a group of authors led by Sara Ghorashian, Developmental Biology and Cancer, of University College London’s Great Ormond Street Institute of Child Health in London.
The survey was sent to 118 centers, and 49 responded from centers in 12 countries, for a response rate of 42%. The survey was posted in July 2020 but asked participants to provide a snapshot of the pandemic’s effects from January through November 2020.
At the time of survey completion, 25 of 49 centers (51%) were in partial lockdown, defined as no local/regional travel restrictions and phased reopening of stores. An additional 4% were under complete lockdown, defined as permission only to attend essential jobs, buy food or medicine, or go to the hospital. The rest (45%) did not have any restrictions at the time.
Overall, 25 of 49 (51%) of responding centers reported a reduction in departmental capacity for patients as a result of COVID-19. Common reasons for capacity reduction were patient factors (for example, unwilling or unable to travel), reduction of inpatient beds, reduced access to an intensive care unit (ICU), reduced clinical trial activity, confirmed or suspected COVID-19 infection, and reduced outpatient services. Less common reasons included delays from manufactures and reduced access to tocilizumab.
In addition, 14 of 49 of responding centers (29%) experienced delays in CAR T-cell therapy. Common reasons for delays included less access to an ICU, staffing reductions, fewer inpatient beds. Of note, the average delay was about a month, but some delays lasted as long as three months. Some delays were indefinite, leading to cancellation of treatment, disease progression, complications, and fatality.
“These data … are relevant to CAR T centers and health authorities for policy planning in response to successive pandemic waves and complement data from the biopharmaceutical industry highlighting the impact of the pandemic on cell and gene therapy discovery as well as delivery of licensed products,” the authors wrote. “Where possible, delays to CAR T-cell therapy delivery should be minimized to prevent adverse effects on patient outcomes, including the need for additional therapies and severe CAR T-related toxicities known to be associated with a greater disease burden.”