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

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 policies^1,3,4.
• 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.