Closing out their discussion on TIL therapy, Drs Sarnaik and Komanduri identify existing barriers to TIL use in clinical practice and how the field might optimize patient access to these regimens.
Krishna Komanduri, MD: The last thing that I might add is something that’s decidedly nonimmunologic and that’s that I think we really have to make sure, as a field, and I think this has to be a collaboration between developers and physicians and even payers, both government and private payers, is to make sure that we have access to these therapies.
One of the things that I’ve seen and have been increasingly thinking about is systems and how we succeed is a troubling trend that, first, not everybody has equal access in this country. That’s dictated by racial and socioeconomic and structural features as well as in part by the cost of these therapies and the difficulty of getting them to people. And as we look at individuals, for example, who have received all T-cell therapies including giving CAR T therapies, you start to see more skewing; in other words, traditional factors that affect access, whether it’d be racial or socioeconomic, tend to be exaggerated as we have these high-cost complex technologies that require not being treated in the rural center where you live but getting to an expert like you or me at the H. Lee Moffitt Cancer Center, Tampa, Florida or UCSF [University of California, San Francisco] where you have to take some effort to get there. And it’s going to be harder. Individuals who historically had access barriers whether culturally, educationally, or economically are less likely to get to us.
I would say you’re absolutely right. I don’t think I can add to your thoughtful summary of the immunologic issues, but I want to make sure as we move forward that we do everything we can to make sure that these therapies, which are breakthrough therapies, are keeping people alive longer, already in clinical trials, and will do so even more once they’re approved, get to everybody, and that we work as hard as we can in a collaborative way to make that happen.
Amod Sarnaik, MD: I think that’s a great way to end this session. I’d like to thank OncLive®for having afforded us the opportunity to get TIL [tumor-infiltrating lymphocyte] cell therapy to the forefront. And I’d like to thank my colleague, Krishna Komanduri MD, for sharing his excellent expertise.
Krishna Komanduri, MD: Thank you. My brilliant pleasure, and I want to join you in thanking the OncLive® group and our audience for paying attention this long. Thanks so much.
Transcript edited for clarity.