Dr. Shaughnessy on Addressing Challenges With CAR T-Cell Therapy in Hematologic Malignancies

Paul J. Shaughnessy, MD, hematologist, oncologist, and medical director of Adult Blood and Marrow Transplant Program at the Methodist Hospital, discusses the challenges faced with CAR T-cell therapy in hematologic malignancies.

The biggest challenge seen with CAR T-cell therapy is that the patients who need this treatment can be very sick; if they have relapsed/refractory disease, it can be rapidly growing, says Shaughnessy. Some of these patients do not have time to have their own lymphocytes collected, genetically engineered, and grown into these CAR T cells.

As such, these patients might not be able to receive treatment with this modality in a timely manner, according to Shaughnessy. However, efforts are being made to overcome this challenge. Experimental methods are being used to develop CAR T-cell therapy from allogeneic donors, allowing the CAR T-cells to be available off the shelf or in a more rapidly accessible; this would allow for more patients to receive treatment more quickly.

Also, many patients with these very advanced cancers will relapse, this needs to be addressed by making better CAR T-cell therapies, says Shaughnessy. Different strategies to achieve this may include making the CAR T cells target 2 antigens instead of just 1, augmenting the therapy with other agents that may increase the immune response, or using radiation to treat relapses before or after the treatment. The field is going to see many advances made in the future, making these therapies more readily available and more effective in patients with hematologic malignancies, concludes Shaughnessy.