5 ms·

Physician here: CAR-T is a potentially amazing technology, but really only works in a small sub-set of the patients for which it is tried. For now

beefman 9y ago
Maybe if you tried it as a first-line treatment instead of on relapsed basket cases it'd work better.
- cryoshon 9y ago
  yeah, when i was working on CAR-T stuff a few years ago this was the thing we always said. most of the mouse models that we prove the therapies in (at least to start) are treatment-naive, which makes a difference.
  - drjasonharrison 9y ago
    and mice are very poor substitutes for humans.
- aaavl2821 9y ago
  Tox is very severe and the cost of drug plus managing the side effects is massively expensive. So the risk / benefit and health economics are worse in early stage cancer. They'll study it in earlier stage at some point probably
mombul 9y ago
Normal person here: why?
- josephv 9y ago
  Bad reddit - why aren't physicians normal people?
  - AnimalMuppet 9y ago
    In this context, pretty clearly, "normal" means "having a layman's understanding of medicine". Physicians had better not be normal (in this sense).
    - mombul 9y ago
      Just took the words out of my mouth, thanks ^^
- aaavl2821 9y ago
  This far it only works in blood cancers, specifically B cell lymphomas. The approved CAR-Ts target a molecule called CD19 expressed on B cells It has not worked widely in solid tumors for a variety of reasons, including immune suppression within the tumor microenvironemnt and difficulty finding antigens that are widely expressed on tumors but not also expressed on healthy cells (so you don't kill healthy tissue in addition to the tumor)
rohitsethi 9y ago
What do you think of US companies like https://www.adaptivebiotech.com/ https://www.adaptivebiotech.com/ and their work ?
psychometry 9y ago
That's not entirely true. It's very effective against blood cancers but less so for solid tumors, where its effect seems to interact strongly with aspects of the tumor microenvironment.
- baldfat 9y ago
  As the father of a kid that died of bone cancer that is par for the course. Other cancers have made HUGE improvements but the hard dense sarcoma tumors still sit in the 1980s in terms survival rates.
  - chrshawkes 9y ago
    I'm very sorry to hear of your loss. I can't begin to imagine.
  - sp821543 9y ago
    An unimaginable loss. I am so sorry.
  - kk58 9y ago
    My commiserations

beefman 9y ago

Maybe if you tried it as a first-line treatment instead of on relapsed basket cases it'd work better.

cryoshon 9y ago
yeah, when i was working on CAR-T stuff a few years ago this was the thing we always said. most of the mouse models that we prove the therapies in (at least to start) are treatment-naive, which makes a difference.
- drjasonharrison 9y ago
  and mice are very poor substitutes for humans.
aaavl2821 9y ago
Tox is very severe and the cost of drug plus managing the side effects is massively expensive. So the risk / benefit and health economics are worse in early stage cancer. They'll study it in earlier stage at some point probably

mombul 9y ago

Normal person here: why?

josephv 9y ago
Bad reddit - why aren't physicians normal people?
- AnimalMuppet 9y ago
  In this context, pretty clearly, "normal" means "having a layman's understanding of medicine". Physicians had better not be normal (in this sense).
  - mombul 9y ago
    Just took the words out of my mouth, thanks ^^
aaavl2821 9y ago
This far it only works in blood cancers, specifically B cell lymphomas. The approved CAR-Ts target a molecule called CD19 expressed on B cells It has not worked widely in solid tumors for a variety of reasons, including immune suppression within the tumor microenvironemnt and difficulty finding antigens that are widely expressed on tumors but not also expressed on healthy cells (so you don't kill healthy tissue in addition to the tumor)

rohitsethi 9y ago

What do you think of US companies like https://www.adaptivebiotech.com/ https://www.adaptivebiotech.com/ and their work ?

psychometry 9y ago

That's not entirely true. It's very effective against blood cancers but less so for solid tumors, where its effect seems to interact strongly with aspects of the tumor microenvironment.

baldfat 9y ago
As the father of a kid that died of bone cancer that is par for the course. Other cancers have made HUGE improvements but the hard dense sarcoma tumors still sit in the 1980s in terms survival rates.
- chrshawkes 9y ago
  I'm very sorry to hear of your loss. I can't begin to imagine.
- sp821543 9y ago
  An unimaginable loss. I am so sorry.
- kk58 9y ago
  My commiserations