Bears watching.
Bears watching.
http://blogs.sciencemag.org/pipeline/archives/2016/07/08/car-t-deaths-cannot-be-good
http://blogs.sciencemag.org/pipeline/archives/2016/07/08/car-t-deaths-cannot-be-good
http://blogs.sciencemag.org/pipeline/archives/2016/07/08/car-t-deaths-cannot-be-good
http://blogs.sciencemag.org/pipeline/archives/2016/07/08/car-t-deaths-cannot-be-good
Dang. Hopefully they have isolated the problem factor and can get back on track.
ReplyDeleteIt's not ideal, no; but (for non-medical folks) the context is critical. CAR T-cell therapy is for patients who have leukemia that broke through every other existing therapy; and leukemia (like most blood cancers) is fast growing. So in most cases, the alternative to attempting CAR T-cell therapy, is deciding how you want to spend the last few weeks of your life.
ReplyDeleteThere's no question that this whole emerging class of immunotherapies therapies are often extraordinarily risky. We simply don't (yet) understand the immune system in exhaustive detail. We know a hell of a lot more than we did ten years ago, and we'll know a hell of a lot more ten years from now, but in the meantime we do the best with what we know. We thus truly don't know yet with absolute certainty everything that's going to happen when we start trying to drive the immune system into overdrive to hunt down tumors that resisted everything else in our arsenal. If we had any alternatives, we'd use them, and not take all the risks that come with fucking with the immune system. So I'm not surprised that we're learning - the hard way - bad shit can happen in ways we didn't fully predict.
The important thing is that we learn (and I'm sure we will learn) exactly what it is about the fludarabine - Juno CAR combination that caused these fatal losses. From our failures come new knowledge, that will help the next generation of patients. We will get better at this, thanks to the to the courage - and sacrifice - of the patients who dared to try.