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How Clinical Trials and Education Are Refining CAR T

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Published on March 28, 2020

Key Takeaways

“Part of the refinement though, I think, is the expectation and the education of all those caring for patients with CAR T,” says Dr. Danielle Brander, explaining the importance of educating health care professionals about CAR T-cell therapy. While still limited to clinical trials for CLL, the FDA has approved CAR T for commercial use in some lymphomas.

Dr. Brander, a chronic lymphocytic leukemia (CLL) expert from Duke Cancer Institute, discusses the evolving landscape of CAR T as it transitions from clinical trials to commercial use. She also provides examples of when and how the safety of CAR T-cell patients would depend on physician knowledge and hospital protocols. Watch now to learn from a CLL expert.

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Transcript | How Clinical Trials and Education Are Refining CAR T

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.

Andrew Schorr:                      

Dr. Brander, you at Duke are getting involved in this now. But at some of the very early centers, they started doing it and in lymphomas as well, some where it’s even approved. And they realized things like—what is it—cytokine release syndrome and other things that happen that could be pretty dramatic as your body goes to war with the cancer cells. As you enter it, do you feel that the approach for CAR T is getting refined? 

Dr. Brander:                

So, that’s an excellent question. I think part of the approach is, I think, two-fold from the very, very early, initial experiments with CAR T. Now that patients have been treated, the approach is being refined, and the target, or what we call prophylaxis, trying to prevent side effects.

So, what should patients have on-board for treatment before they get the CAR T or afterwards? Part of the refinement, though, I think is in a way the expectation and the education of all of those caring for patients with CAR T. 

So, at Duke, like at a lot of major centers, as you just alluded for lymphoma, there are FDA-approved CAR T. So, patients are being treated off trials now as an approved regimen. And then, of course, we also have clinical trials for CLL, for lymphoma, for many other hematological malignancies. So, I think one of the biggest refinements in treating patients is the way, here at Duke and many of the other centers, we’ve learned how big the education at the center has to be. 

So, as we start treating patients, both on trial and for the commercially approved products, there have been huge educational initiatives to think of, “If a patient comes through the emergency room, who all needs to know about CAR T and caring for these patients?” Obviously, when patients are being admitted, most of us have electronic medical record and ordering systems. So, what are the safeguards in place through that? Through protocol driven of cytokine release or—another one of the major toxicities we watch out for is neurological toxicity. How do you build that in? 

So, I think part of the refinement has been in the actual design of the product, but I think a huge part of the safety refinement has been how centers are both educating and building into systems protocols of how to treat different stages of this. And most of our work here has drawn off from the other academic centers that have treated patients. And, of course, as you know, patient’s engagement, education of them and their caregivers, and asking up front for all these safeguards to be put in place is really important part of the safe treatment for patients.

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.

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