Dr. Galal on Ways of Extending the Reach of CAR T-Cell Therapy

Ahmed Galal, MD, instructor, Department of Medicine, Duke Cancer Institute, discusses ways of extending the reach of CAR T-cell therapy in real-world practice.

Real-world evidence suggests that patient selection should be optimized so that more of those who are eligible to receive CAR T-cell therapy can, says Galal. For example, there are approximately 12,000 patients in the United States with relapsed/refractory diffuse large B-cell lymphoma who are eligible to receive the therapy; however, to date, only approximately 1,000 patients have been treated with this approach, he adds. To improve upon this, providers must identify and refer potential candidates earlier on in their treatment course.

Secondly, there are many financial barriers that prevent widespread access to eligible patients, says Galal. In terms of response rates, physicians have to figure out how to extend the persistence of CAR T cells, as many patients will relapse shortly after receiving their transfusion. Additionally, cytokine release syndrome is a common adverse event associated with the therapy that, if circumvented, would increase the feasibility of this approach, concludes Galal.