Currently, five chimeric antigen receptor T-cell (CAR-T) therapies are approved for the treatment of hematological malignancies including acute lymphoblastic leukemia, B-cell lymphoma, non-Hodgkin lymphoma and multiple myeloma. Despite reporting high response rates, the use of CAR-T therapy is associated with a number of challenges, including treatment-related adverse events such as cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS), as well as high costs and manufacturing difficulties. It is thus crucial to reduce the incidence and optimize the management of toxicities through careful patient selection and monitoring. CAR-T therapy is also being explored as a treatment option for chronic lymphocytic leukemia (CLL), where attempts with CAR-T have been unsuccessful due to CLL-induced T-cell dysfunction, a process that is not well understood.

In this podcast, Arnon Nagler, MD, MSc, of the Chaim Sheba Medical Center, Tel-Hashomer, Israel, Anna Sureda, MD, PhD, of the Catalan Institute of Oncology, Barcelona, Spain, Christian Chabannon, MD, PhD, of the Institut Paoli Calmettes, Marseille, France, and Arnon Kater, MD, PhD, of the University of Amsterdam, Amsterdam, Netherlands, discuss key considerations for the use of CAR-T therapy in clinical practice, as presented at the 4th Annual Meeting of the International Academy for Clinical Hematology (IACH) 2021.