CAR T-Cell Therapy: Breaking Down Barriers to Life-Saving Cancer Care

Now, Dr. McGuirk, CAR T is considered a curative therapy for some blood cancers.

Talk to us a little bit about which ones those are.

You betcha.

Uh, acute lymphoblastic leukemia in children and in adults, the standard of care for a relapsed, refractory, not responding to treatment, or even relapsing after a stem cell transplant, uh, represents the standard of care in the United States now with a overall response rate of, uh, greater than 90% in those patients as a curative therapy for those patients.

Non-Hodgkin's lymphomas, a broad array of B-cell non-Hodgkin's lymphomas, the most common forms of non-Hodgkin's lymphoma in the United States, are eligible for CAR T-cell therapy.

Ag- uh, and then finally, multiple myeloma, which Dr. Abdulla will speak to a little bit more, that's moved up in our armamentarium.

Uh, and just two points to, uh, to the, uh, issue of, uh, access, uh, and the issue of moving things up front.

We've shown in a publication from our center that the further patients live from the center, the less likely it is that they're going to be able to access a CAR T-cell, uh, therapy.

Uh, and so we can contend with that.

We have a research study you mentioned earlier we'll talk about, uh, to tackle that problem.

And then in terms of moving to the front line, these therapies proved their worth, uh, in the absolute worst-case scenario where patients had relapsed after all prior therapies, like Michael Fong, uh, and they were doomed.

They, those patients almost universally died historically, and now we're, we're saving their lives, a substantial percentage of them.

Uh, once you've proved your worth in, in the worst-case scenario, it starts moving up, and we're in the second line now.

We're gonna see these therapies, and we actually have studies in our institution, uh, ongoing currently to, to look at CAR T in a front line.

Yeah, I would say, uh, does that make sense to you that m- maybe if we get a front line, we'll even have a better result, or does it... uh, what do you tell me?

That is certainly the hope, that this will be a better result with less toxicity than our conventional traditional therapies.

And is the problem in access to care for patients because people just don't know about it or because insurance doesn't pay for it? What is it?

Insurance pays for it.

It represents standard of care, so we really don't have very many barriers with insurance.

Those who are uninsured, um, are, uh, are a challenge, but even those, we can secure insurance for them.

That's a lesser problem.

Uh, the more c- uh, common issues that we're confronted with are education of referral providers and their teams, uh, out there, uh, and education of the public, uh, and then also improving access.

The further you live from a comprehensive cancer center like ours, the less likely it is that you're going to get into that center and have state-of-the-art therapy or access to a clinical trial or a complex therapy that is standard of care like CAR T-cell therapy.

Um, uh, a- and that's really unfortunate because those patients succumb, uh, often unnecessarily, and we've, we've published in that regard recently, uh, based on a national study we just published in Blood Advances with our colleagues at Sloan Kettering, where we looked at 10,000 patients around the country.

And again, this is a curative therapy for patients in the second or third line for lymphomas.