Role of Frailty in Assessing Eligibility for CAR T‐Cell Therapy in Haematology

Background and Objectives Frailty is a key consideration in determining whether a patient is robust enough for CAR T‐cell therapy; however, it should not represent a barrier to treatment. Our study aimed to describe the extent of research concerning frailty in haematology adult and paediatric patients being considered for CAR T‐cell therapy and its potential impact on their eligibility. Methods Following the Joanna Briggs Institute guidelines, we adopted a scoping review methodology. Our search was conducted across the databases CINAHL, Cochrane, Embase, Medline, PubMed, Google Scholar, clinicaltrials.gov , clinical trials register.eu, and euclinicaltrials.eu for studies published from 2017 to March 2nd 2024. Studies were screened by independent teams of reviewers using the web application Rayyan. Results Our review included 12 studies, with varied study designs. No study in a pediatric CAR T‐cell setting was found. A wide variation in assessing frailty before CAR T‐cell therapy was evident, with ECOG being the most frequently used assessment tool. Conclusions An appropriate frailty assessment before CAR T‐cell therapy promotes the productive use of resources and proper patient selection. Using a geriatric assessment and incorporating an assessment tool such as the CAR HEMATOTOX has the potential for assessing frail CAR T‐cell therapy patients.