Dr. Shah Discusses Challenges With CAR T-Cell Therapy in Myeloma

Nina Shah, MD, associate professor of medicine at the University of California, San Francisco Helen Diller Comprehensive Cancer Center, discusses challenges with chimeric antigen receptor (CAR) T-cell therapy in multiple myeloma.

The biggest concern 1 year ago was cytokine release syndrome (CRS), says Shah. Although CRS is still commonly seen in approximately 63% of patients, it is relatively well-controlled. Physicians have more experience now—they know when to administer dexamethasone and other agents—and as such, are more comfortable with dealing with it, explains Shah. Concerns over safety have now been replaced with efficacy and durability concerns, she adds.

Another challenge with implementing this therapy into practice has been financial. Physicians are still unsure how much each product is going to cost, who will reimburse it, and who will be eligible to receive reimbursement. Those questions will need to be addressed before research is taken any further, as they play an important role in the accessibility and the applicability of this therapy, concludes Shah.