Dr. Perl on Remaining Challenges with CAR T-Cell Therapy

Alexander E. Perl, MD
Published: Wednesday, May 23, 2018



Alexander E. Perl, MD, associate professor of medicine, University of Pennsylvania, discusses remaining challenges with chimeric antigen receptor (CAR) T-cell therapy.

Perl says that the big problems are figuring out how to make CAR T-cell therapy safe for patients, and to make it more widely available. This has been challenging due to the rate of cytokine release syndrome, which can be traumatic and life-threatening. The neurotoxicity is unpredictable, and there currently is no appropriate therapy to fully mitigate its complications. The products can be associated with cerebral edema where the neurotoxicity can be quite dangerous, Perl adds.

Additionally, Perl says that clinicians are still trying to figure out the best supportive care practices for managing patients who receive CAR T-cell therapy. This involves determining how to optimize patients to reduce the risk of toxicities.

Lastly, Perl says that achieving durable responses in each patient remains a challenge. There are patients who receive CAR T-cell therapy and respond, then lose that response. There are also patients who never get a response in the first place.


Alexander E. Perl, MD, associate professor of medicine, University of Pennsylvania, discusses remaining challenges with chimeric antigen receptor (CAR) T-cell therapy.

Perl says that the big problems are figuring out how to make CAR T-cell therapy safe for patients, and to make it more widely available. This has been challenging due to the rate of cytokine release syndrome, which can be traumatic and life-threatening. The neurotoxicity is unpredictable, and there currently is no appropriate therapy to fully mitigate its complications. The products can be associated with cerebral edema where the neurotoxicity can be quite dangerous, Perl adds.

Additionally, Perl says that clinicians are still trying to figure out the best supportive care practices for managing patients who receive CAR T-cell therapy. This involves determining how to optimize patients to reduce the risk of toxicities.

Lastly, Perl says that achieving durable responses in each patient remains a challenge. There are patients who receive CAR T-cell therapy and respond, then lose that response. There are also patients who never get a response in the first place.

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