CAR T in Autoimmune Disease and Key Takeaways

In this segment the panelists, Dr. Samir Parekh and Dr. Saurabh Mehandru, of Mount Sinai in New York, look ahead and close the discussion. Dr. Mehandru notes that chimeric antigen receptor (CAR) T-cell therapy is itself moving into inflammatory bowel disease, with trials underway in parts of Europe including Germany and planning underway at his own institution, which makes patient selection and construct design central questions, and he anticipates more specific and shorter-lived approaches. Dr. Parekh adds that similar trials are opening for autoimmune disease with both CAR T-cell therapy and bispecific antibodies, and describes the group at Mount Sinai that brings gastroenterologists, rheumatologists, transplant specialists, and myeloma specialists together to make these treatments safer. In closing, Dr. Mehandru advises early recognition, early gastroenterology consultation and endoscopic intervention, direct engagement with pathology, nutritional support, short courses of steroids without creating dependence, and consideration of selective Janus kinase inhibitors in partnership with the myeloma team. Dr. Parekh's take-home message is to involve gastroenterology early and not to dismiss immune effector cell-associated enteritis/colitis in patients presenting well beyond the immediate post-infusion period.

This Insights Video was supported by Janssen Pharmaceutical. Content independently developed and published by OncLive.