Barriers to Chimeric Antigen Receptor T-Cell (CAR-T) Therapies in Clinical Practice

Published in: Pharmaceutical Medicine, Volume 36, pages 163–171 (2022). doi: 10.1007/s40290-022-00428-w

Posted on RAND.org on September 15, 2022

by Ajeet Gajra, Abigail Zalenski, Aishwarya Sannareddy, Yolaine Jeune-Smith, Kandice A. Kapinos, Ankit Kansagra

Read More

Access further information on this document at Pharmaceutical Medicine

This article was published outside of RAND. The full text of the article can be found at the link above.

Chimeric antigen receptor T-cell (CAR-T) therapy is a revolutionary cancer treatment modality where a patient's own T cells are collected and engineered ex vivo to express a chimeric antigen receptor (CAR). These reprogrammed CAR-T cells, when reinfused into the same patient, stimulate a T-cell mediated immune response against the antigen-expressing malignant cells leading to cell death. The initial results from pivotal clinical trials of CAR-T agents have been promising, leading to multiple approvals in various hematologic malignancies in the relapsed setting, including acute lymphoblastic leukemia (ALL), diffuse large B-cell lymphoma (DLBCL), mantle cell lymphoma, follicular lymphoma, and, more recently, multiple myeloma. However, since the initial trials and US Food and Drug Administration approvals, there have been significant barriers to the widespread use of this therapy. The barriers to the use of CAR-T therapy include complex logistics, manufacturing limitations, toxicity concerns, and financial burden. This review discusses potential solutions to overcome these barriers in order to make this life-changing therapy widely accessible.

Research conducted by

This report is part of the RAND Corporation External publication series. Many RAND studies are published in peer-reviewed scholarly journals, as chapters in commercial books, or as documents published by other organizations.

The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.