EBMT-EHA CAR-T 2019 | Integration of CAR T-cell therapy: working with industry

So already, we do in hematology work with multidisciplinary teams. So hematopoietic stem cell transplantation, particularly allogeneic, you do need to interact with a lot of specialties. So in a sense this is integrating CAR T-cell therapy into clinical practice is extending that working relationship, maybe firming it up with specific specialties like ITU and urology. But it’s a similar principle.

I think the very different way of working is with the pharmaceutical companies because you know in the past they develop a new drug, they get it licensed, they get it funded, and then really we could use it without their involvement. Whereas now they remain involved, they’re involved in the manufacturing, they have their own quality assurance systems and it introduces interesting questions.

So for example, if you want to use a CAR T-cell products in a patient who’s just outside of the licensed indication, maybe they’re a little bit too young or maybe they’ve got disease in slightly the wrong place, doesn’t quite fall under the license, in the past we’d be able to use a drug in that indication. We have governance systems within our hospitals where we can use unlicensed medications fairly easily as long as they’re funded. Whereas now we’ve got the drug company who usually have much less flexibility in working outside of a license. So quite how these issues will be resolved, I don’t know, but it’s a fascinating time.