Real-world outcomes with outpatient vs inpatient cilta-cel administration in heavily pretreated RRMM

Real-world data from a retrospective cohort study, comparing inpatient vs outpatient administration of ciltacabtagene autoleucel (cilta-cel) in patients with relapsed/refractory multiple myeloma (RRMM) after ≥4 prior lines of therapy (LoT), were published in the Journal of Medical Economics by Janakiram et al. The study consisted of an inpatient cohort (n = 148) and an outpatient cohort (n = 94). 

Key data: Over the first 3 months post-infusion, the outpatient cohort had fewer inpatient days per patient per month (PPPM) vs the inpatient cohort (2.4 vs 6.6; adjusted incidence rate ratio [aIRR], 0.37; 95% confidence interval [CI], 0.28–0.48; p < 0.001) but had more outpatient days (8.5 vs 5.4; aIRR, 1.43; 95% CI, 1.26–1.63; p < 0.001). Rates of treatment-free interval (TFI) and overall survival at 6 and 12 months as well as rates of cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) were comparable between the groups.

Key learning: These findings support the feasibility of outpatient cilta-cel administration in patients with heavily pretreated RRMM, offering comparable effectiveness and safety to inpatient administration while meaningfully reducing inpatient resource utilization.