CAR T

Current challenges and needs

  • Lack of availability to more types of patients
  • Lack of availability for more types of cancers, including solid tumors
  • High costs related with CAR T cells treatment preparation process
  • Lack of education programs for medical staff to identify and treat serious side effects Guidelines for medical centers to be able to apply CAR T Cell therapy

 

Things you should know about CAR T cell therapy

# Two types of therapies available
CAR T Cell therapy is now only approved for treating two types of blood cancers:

Tisagenlecleucel (Kymriah®)

EMA label: Pediatric and young adult patients up to 25 years of age with B-cell acute lymphoblastic leukemia (ALL) that is refractory, in relapse post-transplant or in second or later relapse.

Adult patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) after two or more lines of systemic therapy.

Axicabtagene ciloleucel (Yescarta®)

EMA label: Adult patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) and primary mediastinal large B-cell lymphoma (PMBCL), after two or more lines of systemic therapy.

# Not yet for solid tumor cancers
Results of clinical trials on solid tumors are still preliminary. Many solid tumors have multiple genomic mutations and the tumor can become resistant to treatment.

# Risk of severe side effects
The side effects of CAR T cell therapy, especially a condition known as cytokine release syndrome (CRS), can be life-threatening. Therefore, EMA and FDA require that hospitals applying CAR T cell therapy have staff certified and trained to recognize and manage CRS.

# Weeks to prepare a treatment
The process of making CAR T cells is extremely complex. From start to finish, the process may take up two to three weeks.

# But then it might work long term
If the treatment works as desired, the engineered T cells could be on duty for the rest of the patient’s life and cure would be in sight.

 

Expert View

J. Delgado, MD, PhD (Consultant & Hematologist, Hospital clinic de Barcelona, Barcelona, Spain) & Prof. Stan Riddell (Scientific Director Cancer Immunotherapy Program at the Fred Hutchinson Cancer Research Center, Seattle, USA)