There are still big unanswered questions about CAR therapies: one is how long they last.
That
is hard to tell because of the small numbers of patients treated so
far, and because many of those whose cancer went into remission after
the CAR therapies subsequently became eligible for stem-cell
transplants which can themselves prolong survival.
Another
concern is a potentially dangerous side effect called “cytokine-release
syndrome,” an immune response which shows the therapy is working, but
which can cause a sharp drop in blood pressure and surge in the heart
rate.
The deaths of two patients in a
Juno-backed Sloan-Kettering trial in March caused a temporary halt in
the study because of worries over these immune responses.
“Patients
need to be healthy enough to combat that side effect,” says Mr. Bishop,
who thinks it is now manageable. The trial is recruiting patients
again, excluding those with a risk of heart failure, and giving those
with very advanced leukemia fewer modified cells.
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