Longitudinal Collection of Patient-Reported Outcomes and Activity Data during CAR-T Therapy: Feasibility, Acceptability, and Data Visualization

SIMPLE SUMMARY: Patients treated with chimeric antigen receptor T-cell therapy (CAR-T) are at risk for severe toxicities post-treatment. Patient-reported outcomes and activity data from fitness trackers could be helpful for monitoring patients after CAR-T. The aim of this pilot study was to test the feasibility and acceptability of having patients complete surveys on a rigorous schedule and wear a Fitbit tracker continuously, from before their CAR-T infusion through 90-days post-infusion. In a sample of 12 patients with hematologic malignancies, we demonstrated feasibility and acceptability, with high rates of behavioral adherence to the study procedures. These findings suggest that large-scale data collection efforts using these procedures will be successful. In turn, patient-reported outcomes and activity data could be used to identify predictors of severe CAR-T-related toxicities. ABSTRACT: Background: Clinicians must closely monitor patients for toxicities after chimeric antigen receptor T-cell therapy (CAR-T). Patient-reported outcomes (PROs) (e.g., toxicities, quality of life) and activity data (e.g., steps, sleep) may complement clinicians’ observations. This study tested the feasibility and acceptability of collecting PROs and activity data from patients with hematologic malignancies during CAR-T and explored preliminary data patterns. Methods: Participants wore a Fitbit tracker and completed PROs at several timepoints through 90-days post-infusion. Feasibility was assessed with a priori benchmarks for recruitment (≥50%), retention (≥70%), PRO completion (≥70%), and days wearing the Fitbit (≥50%). Acceptability was assessed with participant satisfaction (a priori benchmark > 2 on a 0–4 scale). Results: Participants (N = 12) were M = 66 years old (SD = 7). Rates of recruitment (68%), retention (83%), PRO completion (85%), and days wearing the Fitbit (85%) indicated feasibility. Satisfaction with completing the PROs (M = 3.2, SD = 0.5) and wearing the Fitbit (M = 2.9, SD = 0.5) indicated acceptability. Preliminary data patterns suggested that participants with better treatment response (vs. progressive disease) had a higher toxicity burden. Conclusions: Longitudinal PRO and activity data collection was feasible and acceptable. Data collected on a larger scale may be used to specify risk prediction models to identify predictors of severe CAR-T-related toxicities and inform early interventions.