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    CAR T-cell therapies in treating lymphoma: Pros and cons


    Catherine Bollard, MD, director of the Center for Cancer and Immunology Research at Washington, D.C.-based Children’s National Health System, discussed immunotherapy for non-Hodgkin’s lymphoma at the 2017 American Society of Hematology (ASH) annual meeting, which took place in Atlanta from December 9 to 12.

    Her talk focused on chimeric antigen receptor (CAR) T cells, which are genetically modified for the treatment of lymphoma, and antigen-specific T-cell treatments; the second type of T cells are trained in the laboratory to recognize and kill tumors—in this case, lymphoma.

    Managed Healthcare Executive (MHE) discussed the ASH presentation with Bollard. What follows are some highlights of that conversation.

    MHE: What’s the success rate with CAR T-cell treatments?      

    Bollard: Across the three pharmaceutical studies, over 200 patients have received CAR T cells [for non-Hodgkin’s lymphoma], with an overall response rate of 53% to 82%. I stacked these three studies together and what’s really remarkable is that the six-month complete remission rate across all the studies is almost identical—ranging from 30% to 37% [for complete remission] and ranging from 37% to 41% overall response rate at six months.

    This really does indicate that there’s potency with these products, but longer follow up is needed. Progression-free survival and overall survival is needed before we could truly compare across these different trials. However, we all agree that there are still appreciable toxicities related to CAR T-cells that need to be mitigated.

    MHE: What are the remaining obstacles to overcome with the CAR T-cell therapies?

    Bollard: The expense of these drugs is one. Who’s going to pay for the drugs? There are currently insurance issues with this.

    (Fred Locke, MD, a medical oncologist at Moffitt Cancer Center, tells MHE that Kymriah (tisagenlecleucel) from Novartis costs $475,000, and Yescarta (axicabtagene ciloleucel) from Gilead costs $373,000.)

    Next: How should payers pay for CAR T-cell therapies? 


    Aine Cryts
    Aine Cryts is a freelancer based in Boston. She is a frequent contributor to Managed Healthcare Executive on topics such as diabetes, ...


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