Bruce Cree, MD, PhD, MAS, on How CAR-T for Autoimmune Disease May Impact Patients’ Lives

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The clinical research director of the UCSF Multiple Sclerosis Center also discussed the high expense of producing individualized therapies like CAR-T.

“If we develop therapies that have a substantial effect in patients who aren't responding well to our standard of care treatments, we're of course going to be benefiting lives. These therapies have the potential to be highly durable: you get treated with the CAR-T therapy once—these are your own cells—and they stick around potentially for many years and have the potential to be reactivated and reexpanded later when you need them.”

As more and more companies and institutions have jumped into evaluating chimeric antigen receptor T-cell (CAR-T) therapies, which originally proved their mettle in oncology, for autoimmune diseases such as systemic lupus erythematosus and myasthenia gravis, much discussion has been taking place about how this may change the treatment landscape for autoimmune diseases. An important aspect of this is the actual impact on the lives of patients who suffer from these diseases.

As part of a larger discussion with Bruce Cree, MD, PhD, MAS, a professor of neurology and the clinical research director of the University of California San Francisco (UCSF) Multiple Sclerosis Center, about CAR-T in autoimmune disease, CGTLive® asked Cree about how these therapies may change patients’ lives. Cree pointed out that the patients who stand to benefit the most from these types of therapies are those with autoimmune diseases that have been refractory to standard of care treatment options. He noted that CAR-T may offer the possibility of “curing”, or at least effectively treating these patients’ diseases in a way that currently available drugs do not. On the other hand, Cree also emphasized that because CAR-T therapies are individualized treatments manufactured from a patients’ own cells, the cost of these treatments will be much higher than drugs that can be mass produced with an economy of scale. As such, CAR-T treatments will only be a viable option if they have been demonstrated to be substantially more effective than other available options in a way that justifies this high cost. Cree connected this point back to the need to design rigorous clinical trials in order to meaningfully evaluate whether CAR-T provides substantially more benefit than other potential options. He concluded on a positive note, acknowledging that if this benefit is demonstrated then it will be a major step forward in medicine.

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