Benefits

CAR T-cell therapy delivers large, durable benefits for myeloma patients. In clinical trials, overall response rates for CAR T range from 74-98%, which demonstrates extraordinary impact as a single therapy, even for highly relapsed patients. 

CAR T-cell therapy is a one‑time personalized procedure that may offer a long treatment‑free interval or deep response. Some patients can achieve lasting remissions after CAR-T.

Barriers

There are also barriers to receiving CAR-T. It may not be the right treatment for you, based on factors such as your treatment goals and your overall health. Some barriers to receiving CAR-T include:

• Insurance and cost coverage. CAR T-cell therapies are expensive. They can cost up to $500,000 US dollars without insurance. Some programs tie payment to outcomes. Although some therapies with reduced costs are being developed, they are still not FDA-approved or need more evidence to ensure patient safety and better outcomes. Visit CAR-T financial resources to learn how Medicare and other insurance cover this treatment, along with additional resources to support you in making CAR-T attainable. 
• Your health status. There are limitations to who can receive CAR-T based on their health status. However, many patients treated in real-world settings have been between age 65 and 91 and even have difficulty performing work activities or worse health, have still had benefit.

Read our article Understanding Barriers to CAR T-Cell Therapy for Blood Cancer Patients to learn more. 

Side effects and boxed warnings 

• Cytokine release syndrome (CRS) is a common but treatable side effect that can manifest with fever, low blood pressure, and breathing difficulty.
• Neurotoxicity: People can present confusion or seizures in some cases.
• Blood count drops: low white cells, platelets, risk of infection or neutropenic fever.
• Rare risk (< 1%) of a new cancer, like secondary lymphoma: FDA requires boxed warnings. 
  
• Risk of infections/immunosuppression: Antibiotics are required for at least the first 3 months after CAR-T therapy

If you plan on talking to your care team about incorporating CAR-T in your plan, after this section, you can review: what to ask your doctor?