Collaboration Between Oncologists and Autoimmune Disease Specialists Will be Critical to Bring CAR-T Therapy to the Latter Field

David Porter, MD
Credit: Penn Medicine

For over a decade, chimeric antigen receptor T-cell (CAR-T) therapies have mainly been reserved to the field of oncology. Although, as a greater number of clinical trials are now being initiated for the evaluation of CAR-T products in autoimmune disease indications, more and more doctors and other healthcare professionals are being introduced first-hand to CAR-T as a therapeutic modality.

At the inaugural Cell Therapy for Autoimmune Disease Summit, held November 28-30, 2023, in Philadelphia, Pennsylvania, David Porter, MD, the director of cell therapy and transplant at Penn Medicine, gave a talk on this topic entitled “Developing a CAR-T for Autoimmune Disease Clinical Program Effectively”. In an interview with CGTLive® at the conference, Porter highlighted the main takeaways of his talk, emphasizing the importance of cross-disciplinary collaboration.

CGTLive: Can you give some background info about your talk?

David Porter, MD: I was asked to talk about developing a CAR T-cell program for patients with autoimmune disease. I'm not an autoimmune physician, I'm an oncologist. My specialty is in blood and bone marrow transplant and cell therapy, but we've been giving CAR T-cells to patients with cancer—various hematologic malignancies—for over 13 years now. As such, we have a lot of experience with how to set up a program for cell therapy. I was asked to come to talk about how we would expand beyond the world of cancer and set up a cell therapy program for patients with autoimmune diseases.

What were the key points of your presentation?

During the session, I had an opportunity to review our experience with hematologic malignancies. CAR T-cells have been dramatically effective for many patients with various blood cancers.Then, I talked about how we can translate that into being able to treat patients with autoimmune diseases. We're very used to working within a group of oncologists, hematologists, and blood and marrow transplant physicians to treat patients with cancer. But historically, our cell therapy group doesn't necessarily work with the physicians and their staff that treat autoimmune diseases: the rheumatologists, the nephrologists, dermatologists, neurologists, etc. We certainly have relationships—we know each other, and we share patients back and forth—but we don't have the same experience having a joint program. So we discussed how we've done that at the University of Pennsylvania; how we've developed a multidisciplinary, multifunctional program, where we can treat patients with a variety of diseases with cancer and noncancer diseases with cell therapy. We've set up programs to use cell therapy in dermatologic diseases and now a number of rheumatologic diseases and kidney diseases, and we discussed a lot about what the best structure is, how to do that—first and foremost—safely.

What are the big-picture implications that the healthcare community should take away from this?

I think there are a number of takeaways. Number one, any program that's set up to treat patients with cell therapies has to be set up to maximize patient safety. There has to be a very well-defined and well-structured quality management and quality assurance program. There also has to be a really good educational program. There are so many different people on the care team that need to understand what the treatment is and how to manage it. It requires a lot of collaboration, it requires a lot of organization, it requires a lot of management. But with some forethought and getting people together, I think we can set up a really good structure where we can manage patients with a variety of diseases in the safest possible way and offer them potentially really important, powerful therapies.

This transcript has been edited for clarity.