Journal
PSYCHO-ONCOLOGY
Volume 30, Issue 8, Pages 1294-1301Publisher
WILEY
DOI: 10.1002/pon.5674
Keywords
adoptive immunotherapy; cancer; caregivers; chimeric antigen receptors; quality of life; psycho‐ oncology
Funding
- National Institutes of Health [K23 CA201594, P30 CA762292, T32 CA090314]
- Moffitt Team Science Award
- Participant Research, Interventions, and Measurement Core Facility at the Moffitt Cancer Center & Research Institute
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Research on caregivers of CAR T-cell therapy revealed that pain, anxiety, and burden were major concerns, likely associated with patients' health status. Caregivers' distress did not change over time, except for worsening depression by day 180. Factors such as lower patient performance status were related to worsening caregiver outcomes.
Objective Informal family caregivers provide critical support for patients receiving chimeric antigen receptor (CAR) T-cell therapy. However, caregivers' experiences are largely unstudied. This study examined quality of life (QOL; physical functioning, pain, fatigue, anxiety, and depression), caregiving burden, and treatment-related distress in caregivers in the first 6 months after CAR T-cell therapy, when caregivers were expected to be most involved in providing care. Relationships between patients' clinical course and caregiver outcomes were also explored. Methods Caregivers completed measures examining QOL and burden before patients' CAR T-cell therapy and at days 90 and 180. Treatment-related distress was assessed at days 90 and 180. Patients' clinical variables were extracted from medical charts. Change in outcomes was assessed using means and 99% confidence intervals. Association of change in outcomes with patient clinical variables was assessed with backward elimination analysis. Results A total of 99 caregivers (mean age 59, 73% female) provided data. Regarding QOL, pain was significantly higher than population norms at baseline but improved by day 180 (p < .01). Conversely, anxiety worsened over time (p < .01). Caregiver burden and treatment-related distress did not change over time. Worsening caregiver depression by day 180 was associated with lower patient baseline performance status (p < .01). Worse caregiver treatment-related distress at day 180 was associated with lower performance status, intensive care unit admission, and lack of disease response at day 90 (ps < 0.01). Conclusions Some CAR T-cell therapy caregivers experience pain, anxiety, and burden, which may be associated patients' health status. Further research is warranted regarding the experience of CAR T-cell therapy caregivers.
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