While chimeric antigen receptor (CAR) T-cell therapies have revolutionized the treatment landscape for patients with hematologic malignancies, challenges remain in the management of short-term toxicities, most notably cytokine release syndrome and neurologic symptoms. In nearly all cases to date, optimal management has only been achieved through inpatient admission for frequent monitoring; however, an onsite hospital stay can create a significant burden for the patient.
As part of a study recently presented at the American Society of Hematology (ASH) 63rd Annual Meeting and Exposition in Atlanta, Georgia, a team of researchers developed and implemented a remote system to monitor vital signs and neurologic symptoms for patients receiving CAR T-cell therapy. In this interview with Oncology Data Advisor, one of the study's investigators, Dr. Morie Gertz, Chair of General Medicine at the Mayo Clinic in Rochester, Minnesota, explains the success of the remote patient monitoring system in identifying vital sign changes, expediting hospitalizations, and facilitating management of CAR T-cell therapy–related toxicities.
Oncology Data Advisor: By way of background, what is the importance of providing frequent monitoring for patients receiving CAR T-cell therapy, and what is the significance of the remote patient monitoring system that was developed as part of this study?
Morie Gertz, MD: When patients are receiving CAR T-cell therapy, frequent monitoring is important because the complication rate from therapy is very, very high. The advantage of this remote patient monitoring system is the fact that the patients don't have to be physically onsite. We've provided them with ample equipment so that their heart, blood pressure, and temperature can be monitored remotely. If there's any disturbance, we can detect it from a distance without being worried about them having to spend a month here in Rochester in a hotel.
The monitoring system is simple because the patients can operate it themselves. It doesn't require any great technical expertise. After a single hour of instruction for the patient, then they're able to do it all at home. All of the information is then transmitted for our analysis. If any concerns arise, we can contact the patients and ask them to physically come by.
Oncology Data Advisor: What are the next steps for your research regarding the remote patient monitoring system, and how it can be applied to clinical practice?
Dr. Gertz: I think the system still needs to be refined a little bit, but we are already beginning to apply it to our clinical practice. It's particularly applicable for very old patients who face difficulty in accessing the medical center. The system is also very appropriate for the more intensive types of therapy. We can give the therapy and then let the patients go home rather than having to wait and be monitored. I think that this will eventually become a routine part of any clinical practice administering therapy that requires regular monitoring of these vital signs.
About Dr. Gertz
Morie Gertz, MD, is the Roland Seidler Jr. Professor in the Department of Medicine and Chair of General Internal Medicine at the Mayo Clinic in Rochester, Minnesota. He specializes in the treatment of patients with Waldenstrom macroglobulinemia, amyloidosis, and multiple myeloma, including those undergoing stem cell transplantation and those receiving CAR T-cell therapy. Dr. Gertz serves as a member of the American Board of Internal Medicine's Hematology Approval Committee, and he has authored or coauthored more than 700 manuscripts focusing on research for hematological malignancies.
For More Information
Paludo J, Bansal R, Holland AT, et al (2021). Pilot implementation of remote patient monitoring program for management of CAR-T cell therapy. Presented at: 63rd American Society of Hematology Annual Meeting & Exposition. Abstract 568.
Transcript edited for clarity. Any views expressed above are the speaker's own and do not necessarily reflect those of Oncology Data Advisor.