iwNHL 2018 | CAR T-cell therapy: on the way to success

Steven Rosen

CAR T-cell therapy is paving the way to success in hematological cancers. Here, Steven Rosen, MD, from the City of Hope, Duarte, CA, highlights the effectiveness of this therapy in sending patients into remission, where in some cases, patients have been cured. However, Dr Rosen states there are a percentage of patients that do not benefit from the treatment, and there are yet further challenges of cost, production time and toxicity that need to be considered. He highlights these challenges but is confident that they will be conquered. This interview was recorded at the International Workshop on Non-Hodgkin Lymphoma (iwNHL) 2018 meeting, held in Nice, France.

Transcript (edited for clarity):

CAR-T therapy, we know, is effective. There are patients who now have gone into remission but have been cured where there are no other options, but what we also know is that one: there’s a percentage of patients that don’t benefit, so we want to understand what the limiting factor is. Also, patients that after a dramatic response, relapse and often the target is missing, so, we have to think of strategies to get around that.

You also have the dilemma that these are currently autologous products, so you have to produce them and the individual may have to wait several weeks before the therapy can be administered and there the question is: does the individual have that luxury? Hopefully, in the future there may be off-the-shelf CAR-Ts that’ll address that issue, and then there’s the toxicity.

Predominantly, the cytokine release syndrome and the neurotoxicity, but there are also patients who have problems with coagulopathy and cytopenias and I’m confident that we’ll conquer those problems, but there’s still a lot of work to be done. And then, as was discussed at the meeting, the costs are prohibitive, in particular, for many countries. The United States currently is even struggling with how to effectively pay for this treatment.

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