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2023-07-26T10:44:08.000Z

Answering the common challenges facing real-world CAR T-cell therapies

Jul 26, 2023
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Learning objective: After reading this article, learners will be able to cite the common challenges facing CAR T-cell therapy and possible solutions in development.

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During the EHA 2023 Hybrid Congress, the Lymphoma Hub and Multiple Myeloma Hub held a joint satellite session on the ins and outs of CAR T cells in the real world.

Here, we share the presentation by Michael Hudecek, University Hospital Würzburg, Würzburg, DE, discussing answers to common challenges in CAR T-cell therapy.

In this presentation, Hudecek identifies limitations in patient access and inefficient manufacturing protocols as the main challenges currently restricting the scalability of CAR T-cell therapies (Figure 1), before highlighting some possible innovative answers (Figure 2). 

Figure 1. The effect of limited patient access on CAR T-cell therapy for patients with DLBCL in Italy*  

CAR, chimeric antigen receptor; DLBCL, diffuse large B-cell lymphoma; R/R, relapsed/refractory;
2L, second line.
*Adapted from Jommi, et al.1

 

Figure 2. The impact of centralized CAR T-cell manufacturing on wait times for CAR T-cell infusion*

CAR, chimeric antigen receptor; PoC, point of care.
*Created with BioRender.com

Watch or download the presentation to learn more about the common challenges and solutions facing CAR T-cell therapy today, including:

  • The geographical disparities in CAR T-cell funding and research
  • The current progress towards, and future role of, artificial intelligence in streamlining the manufacturing process of CAR T-cell products
  • The implementation of virus-free gene transfer in current genetic transposition methodologies
  • In vivo CAR T-cell production using nanoparticle-encased gene transfer vectors

Key points

  • Limited patient access and logistical challenges in the manufacturing of CAR T-cell products are major barriers to the wider use of these therapies.
  • Access inequality to education and hands-on practice with CAR T-cell therapies between countries contributes to limited patient access.2
  • The current logistical challenges disrupting the scalability and patient access to CAR T-cell therapy are:
    • CAR T-cell manufacturing restricted to centralized facilities
    • Acquiring clinical grade lentiviral or gammaretroviral vectors
    • High cost of CAR T-cell therapy (between 253,000 and 319,000 USD per QALY)2
    • Inadequate US and EU reimbursement policies1,3,4.
  • Three key areas of CAR T-cell innovation are driving solutions to these challenges:
    • The integration of artificial intelligence into the infrastructure of ‘smart manufacturing hospitals’ to facilitate data management and provide decision support.
    • Virus-free gene transfer, to overcome the difficulties in acquiring suitable retroviral vectors.
    • The simplification of CAR T-cell manufacturing using in vivo gene transfer techniques.

Session slides

To download the slides presented, click here.

Download here

This activity was supported through an educational grant from Bristol Myers Squibb.

  1. Jommi C, Bramanti S, Pani M, et al. CAR T-cell therapies in Italy: patient access barriers and recommendations for health system solutions. Front Pharmacol. Online ahead of print. DOI:3389/fphar.2022.915342
  2. Cappell KM, Kochenderfer JN. Long-term outcomes following CAR T cell therapy: what we know so far. Nat Rev Clin Oncol. 2023;20(6):359-371. DOI: 1038/s41571-023-00754-1
  3. ASGCT.  CAR-T Therapy: Ensuring access to a revolutionary cancer treatment. American Society of Gene + Cell Therapy. https://asgct.org/global/documents/patient-ed-infographics/asgct-car-t-access_one-pager_2-22-21.aspx. Published, 2020. Accessed July 17, 2023.
  4. Hopfinger G, Rupp B, Greil R. Barriers to patient access of CAR T cell therapies in Austria.  2023;16:79-90. DOI: 10.1007/s12254-022-00859-w

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