VIDEO: Patients find CAR-T simpler than transplant

Editor’s note: This is a previously posted video, and the below is an automatically generated transcript to be used for informational purposes. Please notify editor@healio.com if there are concerns regarding accuracy of the transcription.

Patients have a limited knowledge about it, meaning what treatment involves. A lot of patients have undergone transplant, and that's what they remember. One of the main question ends up being is it as bad as transplant? And the good news is that CAR T-cell treatment is much better tolerated than when they go through transplant. I've asked many patients who have had both, original transplant and CAR-T, and almost uniformly unanimously, everybody says this was much simpler than transplant. That's one question they have. The second question ends up being about the side effects and how serious it is. And the typical answer for that is gonna be that yes, CRS can be serious. It is something that happens almost in everybody because it's almost connected with the response in the patient. But what the good answer there is and the fact and the truth is that now over four to five years since we have been doing CAR T-cell therapy, we have learned how to recognize and treat it effectively and early. And so, very early intervention for treating CRS has made it much better manageable and not as serious side effects anymore. There's a drug called tocilizumab, which is given as soon as we recognize CRS of certain level, and that mitigates further complications. And then the third question ends up being about the neurotoxicity. Most of them have heard of it. In myeloma, it's very infrequent. Less than 20% have it. And even when it happens, it's grade one or two, so it's minimal. And I think that's another component. And the last question patient ask is that, do I have to be in the hospital, and/or do I have to be coming to hospital every day? And this is a question that on our studies, we had patients stay in the hospital for two weeks, and even still today, when they go on the study, they stay in the hospital for two weeks. However, on the commercial side, when we do it outside of a study, there is much greater comfort level in doing it outpatient. Depending upon the center, the whole process can be outpatient, or most of it outpatient except a short time when the CAR T-cells are being infused. And then, if and when they get the CRS, they might get readmitted for a shorter period of time for control of it. So I think with gaining experience, everybody's becoming more comfortable doing majority of the part of the treatment as an outpatient, and then recognizing side effects profile, admit them. And finally, do they have to stay close to the center where it is being done? Currently during the acute time phase, that's what we require. Over time, I can see that some of this management can also be done in the community hospital once everyone gets more used to managing it for a reasonable period of time. Although I think we would require a patient to stay somewhere close to where they get their CAR-T, so the physicians who know how to manage them are accessible immediately and they can take care of all the problems.