Patient-reported out comes after CAR T-cell therapy in patients with hematological malignancies

The remarkable improvement in survival among individuals with hematological malignancies receiving chimeric antigen recep tor (CAR) T-cell ther apy has high lighted the grow ing unmet need to incor po rate patient-cen tered assess ments in man age ment guide lines for these patients. That CAR T-cell ther apy is asso ci ated with unique toxicities and rel a tively high symp tom bur den in the first few weeks after cell infu sion is well known. Magnifying the patient's voice by using patient-reported out comes (PROs) might sup port per son al ized inter ven tion in the acute-care set ting, opti mize the use of medical resources, improve satisfaction with therapy, and enhance survival benefit. However, various factors impede PRO use in rou tine patient care: (1) the fea si bil ity of PRO assess ment dur ing the acute phase of treat ment, espe cially in patients expe ri enc ing neu ro log i cal toxicities, is not well established; (2) although PROs are widely used in drugdevel op ment tri als, the assess ment tools used in clin i cal tri als pri mar ily inform qual ity-of-life or safety com par i sons among study arms and are rarely the proper tools for assessing and cap tur ing clin i cally mean ing ful adverse events that should be mon i tored in rou tine patient care; (3) PRO data that could guide how best to mon i tor and cap ture the delayed effects of CAR T-cell ther apy in long-term sur vi vors are lim ited. There is a press ing need to over come these bar ri ers to inte grat ing evi dence-based PROs into stan dard-of-care guide lines for patients receiv ing CAR T-cell ther apy. In this review, we pres ent the cur rent state of PRO uti li za tion in CAR T-cell ther apy. We also dis cuss prac ti cal approaches and future direc tions for suc cess ful implementation of PROs in the care of patients receiv ing CAR T-cell ther apy.