Dr. Nimer on CAR T-Cell Therapy in Hematologic Malignancies

Stephen D. Nimer, MD, professor of medicine, director, Sylvester Comprehensive Cancer Center, University of Miami Health System, discusses the use of chimeric antigen receptor (CAR) T-cell therapy in hematologic malignancies.

CAR T cells have been approved by the FDA for the treatment of patients with acute lymphoblastic leukemia (ALL) and non-Hodgkin lymphoma. Several products are being tested in multiple myeloma as well as in solid tumors, explains Nimer. However, one of the main concerns with CAR T-cell therapy is the duration of response.

As it stands, this approach is quite expensive, and ensuring that patients derive the greatest benefit—and potentially, cure—will be crucial in extending its reach, he adds. In other malignancies, its utility will depend on the setting in which it's used and how long the duration of remission is, explains Nimer.

In addition to CAR T-cell therapy, there are several emerging techniques that are being used to improve immune system response. For example, with the BCL-2 inhibitor venetoclax (Venclexta) has shown efficacy in both lymphomas and leukemias. As fundamental mechanisms in these diseases are uncovered, the number of patients who may need CAR T-cell therapy may ultimately decrease, concludes Nimer.