1. Mediport use as an acceptable standard for CAR T cell infusion.
- Author
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Eylon, Maya, Prabhu, Snehit, John, Samuel, King, Maxwell, Bhatt, Dhruv, Curran, Kevin, Erickson, Courtney, Karras, Nicole, Phillips, Christine, Satwani, Prakash, Southworth, Erica, Baumeister, Susanne, Talano, Julie-An, MacMillan, Margaret, Rossoff, Jenna, Bonifant, Challice, Myers, Gary, Rouce, Rayne, Toner, Keri, Driscoll, Timothy, Katsanis, Emmanuel, Salzberg, Dana, Capitini, Christian, Pacenta, Holly, Pfeiffer, Thomas, Shah, Niketa, Huynh, Van, Skiles, Jodi, Fraint, Ellen, McNerney, Kevin, Quigg, Troy, Krueger, Joerg, Ligon, John, Fabrizio, Vanessa, Baggott, Christina, Laetsch, Theodore, Schultz, Liora, Hermiston, Michelle, De Oliveira, Satiro, and Schiff, Deborah
- Subjects
cancer ,chimeric antigen receptor T cell ,immune cell engineering ,immunotherapy ,implanted catheter ,mediport - Abstract
INTRODUCTION: Mediport use as a clinical option for the administration of chimeric antigen receptor T cell (CAR T cell) therapy in patients with B-cell malignancies has yet to be standardized. Concern for mediport dislodgement, cell infiltration, and ineffective therapy delivery to systemic circulation has resulted in variable practice with intravenous administration of CAR T cell therapy. With CAR T cell commercialization, it is important to establish practice standards for CAR T cell delivery. We conducted a study to establish usage patterns of mediports in the clinical setting and provide a standard of care recommendation for mediport use as an acceptable form of access for CAR T cell infusions. METHODS: In this retrospective cohort study, data on mediport use and infiltration rate was collected from a survey across 34 medical centers in the Pediatric Real-World CAR Consortium, capturing 504 CAR T cell infusion routes across 489 patients. Data represents the largest, and to our knowledge sole, report on clinical CAR T cell infusion practice patterns since FDA approval and CAR T cell commercialization in 2017. RESULTS: Across 34 sites, all reported tunneled central venous catheters, including Broviac® and Hickman® catheters, as accepted standard venous options for CAR T cell infusion. Use of mediports as a standard clinical practice was reported in 29 of 34 sites (85%). Of 489 evaluable patients with reported route of CAR T cell infusion, 184 patients were infused using mediports, with no reported incidences of CAR T cell infiltration. DISCUSSION/CONCLUSION: Based on current clinical practice, mediports are a commonly utilized form of access for CAR T cell therapy administration. These findings support the safe practice of mediport usage as an accepted standard line option for CAR T cell infusion.
- Published
- 2023