Real-world healthcare resource utilization and clinical outcomes among patients with relapsed/refractory multiple myeloma receiving ciltacabtagene autoleucel after four or more prior lines of therapy in inpatient versus outpatient settings.

The majority of patients received cilta-cel in an inpatient setting, with a substantial minority receiving it as outpatients.

• Among 242 total patients identified, 148 (61.2%) received cilta-cel in an inpatient setting and 94 (38.8%) in an outpatient setting.
• Patients were identified from the Komodo Research Database claims data between 02/28/2022 and 06/30/2024.
• All patients had received ≥4 prior lines of therapy before cilta-cel infusion.
• Baseline characteristics were described as comparable between the two cohorts.

Nearly one-third of outpatient cohort patients did not require any inpatient admission within 3 months post-infusion.

• 31.9% of patients in the outpatient cohort did not require an inpatient admission within 3 months post-infusion.
• This finding supports the feasibility of managing cilta-cel administration and its early post-infusion period entirely in outpatient settings for a meaningful proportion of patients.

Outpatient cilta-cel administration was associated with significantly fewer inpatient days per-patient-per-month during the first 3 months post-infusion.

• The outpatient cohort had 2.4 inpatient days per-patient-per-month compared to 6.6 in the inpatient cohort during the first 3 months post-infusion.
• The incidence rate ratio (IRR) was 0.37 (95% CI: 0.28–0.48), p < 0.001.
• From the fourth month post-infusion onward, no significant differences in inpatient healthcare resource utilization were observed between cohorts.

Outpatient cilta-cel administration was associated with significantly more outpatient days per-patient-per-month during the first 3 months post-infusion.

• The outpatient cohort had 8.5 outpatient days per-patient-per-month compared to 5.4 in the inpatient cohort during the first 3 months post-infusion.
• The IRR was 1.43 (95% CI: 1.26–1.63), p < 0.001.
• From the fourth month post-infusion, no significant differences in outpatient healthcare resource utilization were observed.

Rates of cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome were similar between inpatient and outpatient cohorts.

• Rates of CRS (cytokine release syndrome) were reported as similar between the IP and OP cohorts.
• Rates of ICANS (immune effector cell-associated neurotoxicity syndrome) were also reported as similar between cohorts.
• Outcomes were compared using multivariate regression analysis and reported as incidence rate ratios with 95% confidence intervals.

Long-term clinical outcomes including treatment-free interval and overall survival were similar between inpatient and outpatient cohorts.

• 6-month and 12-month treatment-free interval (TFI) were reported as similar between the IP and OP cohorts.
• Overall survival (OS) at 6 and 12 months was similar between cohorts.
• No statistically significant differences in long-term effectiveness outcomes were detected between administration settings.

Outpatient administration of cilta-cel was feasible and increasingly used in real-world clinical practice for RRMM patients after ≥4 prior lines of therapy.

• The study used Komodo Research Database claims data, representing real-world clinical practice across the United States.
• The study period spanned from 02/28/2022 to 06/30/2024, capturing early real-world experience with cilta-cel after its approval.
• The authors concluded that outpatient administration has the potential to reduce the burden on the healthcare system while maintaining clinical effectiveness and safety.