The Fellow on Call: The Heme/Onc Podcast Episode 075: Intro to CAR-T, Bispecifics (BiTE), and Autologous Transplant
Sep 27, 2023
Discover the revolutionary approaches to treating hematologic malignancies, including CAR-T therapy and bispecific T-cell engagers. Learn how CAR-T cells are crafted and the vital side effects to monitor. Dive into the challenges of primary refractory disease and how advanced therapies can pave the way for new hope. Explore the convenience of off-the-shelf BiTE therapies versus personalized CAR-T processes. The discussion also highlights the role of autologous transplants in enhancing treatment outcomes for patients.
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Refractory Lymphoma Patient Case
- A 43-year-old man with HIV-associated high-grade B-cell lymphoma showed persistent disease despite therapy.
- He is now considering CAR-T therapy or high-dose chemotherapy with autologous stem cell transplant.
Lymphoma Relapse and Refractory Disease
- Primary refractory disease and relapse within 12 months share a poor prognosis and are treated similarly.
- CAR-T is standard for these; relapse after 12 months offers better prognosis and may use autologous transplant.
T Cell Challenges in Cancer Immunity
- T cells require antigen recognition and co-stimulation to kill tumor cells, making immune response to cancer complex.
- Tumor cells have self-antigens, so immune system faces challenges in targeting them effectively.