Leo I. Gordon, MD, professor of medicine, Feinberg School of Medicine, Northwestern University, discusses the concerns of chimeric antigen receptor (CAR) T-cell therapy.

When considering the use of CAR T-cell therapy for hematologic malignancies, Gordon first asks, "Does it work?" Preliminary data suggest that it does work in a very heavily pretreated group of patients, with about 50% of patients in remission and 40% to 50% of responses lasting 6 months or longer.

If CAR T-cell therapy works, then Gordon asks, "Is the toxicity manageable?" In an early study of children, researchers found there were issues with neurologic toxicity and blood pressure as well as 4 fatalities from cerebral edema caused by CAR T-cell therapy.

According to Gordon, cell manipulation and how much pre-infusion lymphodepleting chemotherapy are given to balance the growth of the CAR T cells still need to be better understood.

Lastly, what does it cost? There are concerns over the potential financial burden with this type of treatment, he explains. 

Leo I. Gordon, MD

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Dr. Gordon on the Concerns of CAR T-Cell Therapy