Mindy Kupchin, RN

Panelists discuss how patients typically respond well to chimeric antigen receptor (CAR) T-cell therapy with manageable adverse effects (AEs), including expected cytokine release syndrome (CRS) presenting as fever, whereas rare neurotoxicity is closely monitored through frequent cognitive testing and treated with steroids and late immune system effects like urinary tract infections (UTIs), respiratory infections, and shingles occur in the first 6 months post treatment but resolve with appropriate medications and prophylactic treatments, with outcomes improving significantly when CAR T is used earlier in treatment lines rather than after patients have exhausted all other options.

Panelists discuss how nursing support for chimeric antigen receptor (CAR) T-cell therapy success involves providing comprehensive educational materials covering everything from collection to survivorship, conducting virtual CAR T classes, and adapting to new outpatient CAR T protocols where patients receive cells and go home with vital sign monitoring equipment for caregivers. The panelists also celebrate recent FDA regulatory changes that reduced required stay times from 4 weeks to 2 weeks and driving restrictions from 8 weeks to 2 weeks, making CAR T therapy more accessible by allowing patients to return to work and normal life sooner, with reduced financial burden on families.

Panelists discuss how shared clinical decision-making in chimeric antigen receptor (CAR) T-cell therapy involves seamless coordination between physicians and nurse coordinators who streamline the referral process for patients after first-line therapy failure, with coordinators managing logistics like condensing multiple appointments, arranging travel and lodging benefits through CAR T companies for out-of-state patients, providing clear communication in “nurse talk” rather than medical jargon, and emphasizing that the referral process is straightforward—encouraging oncologists not to wait but to send patients immediately after 1 line of therapy so the team can handle insurance approval and T-cell collection while patients return home during the 4- to 8-week manufacturing period.

Panelists discuss how patients with relapsed/refractory (R/R) multiple myeloma experience the challenging process of confirming disease recurrence through bone marrow biopsies and PET scans, often struggling with difficult treatment regimens like immunotherapy and daily lenalidomide (Revlimid) that cause severe illness, leading patients to advocate for themselves by researching alternative therapies like chimeric antigen receptor (CAR) T-cell therapy through educational materials and videos, ultimately seeking second-line treatments that offer the appeal of “one and done” therapy with less ongoing chemotherapy compared with traditional lifelong treatment approaches.

Panelists discuss how patients educate themselves about multiple myeloma through hospital pamphlets and magazines, online research, and positive attitude books about cancer while emphasizing the critical importance of peer support and mentorship programs where patients can meet with others who have successfully undergone treatments like stem cell transplants, creating comforting group meetings that help alleviate fear and provide hope by seeing healthy survivors share their stories and demonstrate that recovery is possible.

Panelists discuss how multidisciplinary care coordination for chimeric antigen receptor (CAR) T-cell therapy involves registered nurses serving as support persons and liaisons between academic centers and community oncologists, with streamlined communication through direct cell phone access, telehealth consultations to assess candidacy, and coordinated logistics for pretreatment testing, including PET scans, bone marrow biopsies, brain MRIs, and lumbar punctures, while emphasizing that CAR T approval has expanded from fourth-line treatment in 2022 to second-line therapy in 2024, allowing for faster patient access through insurance approval and outpatient T-cell collection processes.

Panelists discuss how a patient with multiple myeloma initially experienced severe fatigue, hair loss, swelling from kidney dysfunction, and overwhelming pain before being misdiagnosed with lupus, ultimately requiring emergency care where blood work and bone marrow biopsy confirmed both multiple myeloma and amyloidosis, leading to successful treatment with chemotherapy followed by stem cell transplant that achieved 5.5 years of remission monitored through regular blood draws tracking  light chain levels.

Panelists discuss how multiple myeloma is a rare blood cancer affecting plasma cells that have gone rogue, causing symptoms like fatigue, kidney dysfunction, and bone pain, with approximately 36,000 new cases diagnosed annually in the US, primarily affecting older patients around 60 to 65 years of age. Although multiple myeloma is highly treatable with great therapy options available, the disease often relapses and requires aggressive early treatment approaches, including emerging immunotherapies that may help cure a larger fraction of patients in the future.