Dr. Sweetenham on Unanswered Questions With CAR T-Cell Therapy in Pediatric ALL

John Sweetenham, MD, associate director for clinical affairs, Harold C. Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, discusses unanswered questions with CAR T-cell therapy in pediatric acute lymphoblastic leukemia (ALL).

CAR T-cell therapy is FDA approved for pediatric patients with relapsed/refractory high-risk ALL. This treatment is yielding remarkable results, Sweetenham notes, and as these data mature, it is becoming clear that nearly 50% of patients are achieving long-term remissions after failing all other therapies.

The challenge with CAR T-cell therapy is that it is very expensive, and the patient populations treated on clinical trials are not completely representative of the overall population of patients with pediatric ALL. Identifying the “true” cost of this therapy is not just the cost of the product itself but also managing its associated toxicities, says Sweetenham. Whether CAR T cells can be moved into an earlier setting also needs to be addressed, Sweetenham concludes.