Who Is a Good Candidate for CAR T-Cell Therapy?

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Andrew Schorr:

So CAR-T, chimeric antigen receptor T-cell therapy, taking a virus, I think, and combining it with stuff for your T cells, targeting your CLL.  So Lynne just asked, she's 71, would somebody older like that??tomorrow is my 68th birthday, folks—would we be candidates for CAR?T should we need it?  

Dr. Sharman:

Well, I need to articulate some of my limitations as a community practice oncologist, thus far the CAR-T research has been sort of in the exclusive purview of academic centers, so I haven't had the chance to do it yet.  That having been said, we are working with a variety of sponsors to get such a program up and running.  

However, I will say there's a lot of enthusiasm in CLL because the original New England Journal of Medicine paper that described CAR-T was done in both pediatric acute leukemia and adult chronic lymphocytic leukemia, and it is now approved by the FDA for the pediatric ALL, acute lymphoblastic leukemia.  It is not approved for CLL.  And part of that—there's a lot of reasons why it doesn't work as well in CLL as it does in other diseases, and I think that the—it's okay that this is moving a little bit more slowly in the CLL field because I think we're getting a lot of benefit of accumulating knowledge in how to make it work best in CLL.  I think it will become an important therapy in CLL. 

Keep in mind that the toxicity of chimeric T cell is significant, and the possibility of neurotoxicity or this syndrome that looks a little bit like sepsis that's not sepsis but it looks like it in a lot of ways, what we call cytokine release syndrome make this a therapy where caution is advised. 

And so if it's something you're thinking about, I would say go get yourself seen in your very specific circumstances with somebody doing this in research studies and decide if it's right for you.  

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.