Leo I. Gordon, MD, professor of medicine, Feinberg School of Medicine, Northwestern University, discusses the concerns of chimeric antigen receptor (CAR) T-cell therapy.
When considering the use of CAR T-cell therapy for hematologic malignancies, Gordon first asks, "Does it work?" Preliminary data suggest that it does work in a very heavily pretreated group of patients, with about 50% of patients in remission and 40% to 50% of responses lasting 6 months or longer.
If CAR T-cell therapy works, then Gordon asks, "Is the toxicity manageable?" In an early study of children, researchers found there were issues with neurologic toxicity and blood pressure as well as 4 fatalities from cerebral edema caused by CAR T-cell therapy.
According to Gordon, cell manipulation and how much pre-infusion lymphodepleting chemotherapy are given to balance the growth of the CAR T cells still need to be better understood.
Lastly, what does it cost? There are concerns over the potential financial burden with this type of treatment, he explains.