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    Cellular and T cell engager Immunotherapy

    Category: Cellular and T cell engager Immunotherapy

    Real-world Healthcare Resource Utilization (HCRU) Following Outpatient (OP) or Inpatient (IP) Administration of Ciltacabtagene Autoleucel (Cilta-cel)

    (PA-086) Real-world Healthcare Resource Utilization (HCRU) Following Outpatient (OP) or Inpatient (IP) Administration of Ciltacabtagene Autoleucel (Cilta-cel)

    Friday, September 19, 2025
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    Introduction: OP administration of cilta-cel is feasible due to the predictable side effects of cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS). For relapsed multiple myeloma, OP administration has become more common and can reduce HCRU and expand treatment access. This study describes real-world HCRU following cilta-cel administration in IP and OP settings.

    Methods: We employed the Komodo Research Database (US claims database) to conduct descriptive analyses of HCRU among patients (pts) receiving cilta-cel after 4 or more prior lines of therapy stratified by IP or OP administration from 2/28/2022-6/30/2024. OP administration was defined as cilta-cel infusion occurring as an outpatient. Pts were followed to the earliest of 30 days post-infusion, loss of follow-up, or death. T-tests were used to perform unadjusted outcome comparisons between IP and OP administration cohorts.

    Results: Among 242 pts, 148 (61.2%) received cilta-cel in an IP setting and 94 (38.8%) in an OP setting. Baseline characteristics were comparable in IP and OP cohorts, with respect to median age (IP: 64 yrs, OP: 64 yrs), female sex (IP: 47.3%, OP: 42.6%), median Quan-Charlson Comorbidity Index (IP: 5, OP: 5), and median line of therapy of cilta-cel (IP: 6, OP: 5).

    For IP vs OP cilta-cel administration, all-grade CRS (IP: 58.8%, OP: 78.1%; p< 0.05) as well as fever (IP: 25.0%, OP: 78.1%; p< 0.05) were higher in the OP setting; however, grade ≥3 CRS was lower (IP: 1.4%, OP: 0.0%; p=0.16). ICANS was comparable (IP: 13.5%, OP: 12.5%; p=0.84), including grade ≥3 ICANS (IP: 2.0%, OP: 1.6%; p=0.81), as well as pancytopenia (IP: 64.2%, OP: 70.3%; p=0.38). In the first 30 days post-infusion, use of tocilizumab (IP: 16.9%, OP: 11.7%) and dexamethasone (IP: 12.2%, OP: 13.8%) were similar. The 30-day mortality was similar between IP and OP cohorts (IP: 1.4% [n=2], OP: 1.1% [n=1]; p=0.84).

    The mean number of hospitalization days over the 30 days post-infusion for IP vs OP cilta-cel administration was 14.9 [range: 1, 30] vs 7.7 [range: 1, 26] days (p< 0.001). At day 15 and day 20 post-infusion, the mean number of hospitalization days for IP vs OP administration was 13.0 vs 6.1 (p< 0.001) and 14.0 vs 6.5 (p< 0.001), respectively. Lastly, 31.9% (n=30) of pts with OP administration did not require hospitalization within the first 30 days post-infusion.

    Conclusions: This real-world descriptive analysis demonstrates that OP administration of cilta-cel is feasible, with approximately one-third of pts not requiring hospitalization within the first 30 days post-infusion. The median number of hospitalization days was significantly lower in the OP setting at day 15, day 20, and day 30 post-infusion, showing significantly decreased HCRU. Overall, OP administration offers a pt-centric model, reduced HCRU with similar early safety outcomes, and could be widely adopted.