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Transcript
Jamie Forward:
So, when considering CAR T-cell therapy options, where do clinical trials fit into the plan? Are there CAR T-cell therapy clinical trials that patients can access?
Dr. Danai Dima:
Yes, of course. There are a lot of clinical trials currently testing new CAR T-cell therapy products out there.
And they are great options for patients. We know that all these clinical trials, they have pretty strict eligibility criteria.
And they allow patients to enroll based on their disease characteristics, prior therapies, and timing of the relapse. And some of the clinical trials right now, they assess currently approved product earlier in lines of therapy in newly diagnosed disease, which is pretty innovative. Clinical trials are very important because they expand the treatment options. And they can also offer better products, I would say earlier in the disease course with the aim of getting better efficacy and less toxicity.
Because some of the products we have right now in clinic, they are associated with irreversible long-term neurotoxicities, which sometimes, they can sound pretty scary to patients. And so, patients don’t really want to do CAR T because of that.
Jamie Forward:
Well, what questions should patients be asking their doctor about clinical trials? If they’re having the conversation, are there any questions that they should sort of come in with?
Dr. Danai Dima:
Yes. So, first of all, I would say when you walk into your doctor’s office, just ask them, am I eligible for any clinical trials? And if yes, which are those? What are the differences between this or that clinical trial compared to standard of care therapy, standard of care CAR T we have right now? Sometimes, your doctor might present two different clinical trials, CAR T clinical trials. Just ask, what are the differences between those? Of course, ask what are the potential risks and benefits in participating in the trial? For example, what happens if I have an adverse event during the trial?
Again, trials carry many unknowns, but they can also offer cutting-edge treatments to patients.
And that’s very great when it happens earlier in their disease course. Another important thing to ask is what are the logistics involved. For example, ask about travel or lodging requirements, time commitment because that’s a big thing. A lot of those clinical trials, they need the patients to come to the main tertiary center maybe every week or every other week. And some patients might not be able to do that. So, ask about time commitment` and also about all the additional procedures that they involve because patients know that in real life, we’re not going to go do a bone marrow biopsy every three months because it’s a pretty invasive procedure.
However, maybe the trial requires that. So, I think knowing that upfront is really, really important. And then, I think the last question to ask is what other options do I have after I participate in this clinical trial? We know that myeloma’s an incurable disease.
And we know that at some point, the myeloma will come back. So, I think it’s really important to ask your doctor, what happens if the myeloma comes back? What are the other options? Does participation in this trial limit further options? So, I think that’s a big thing to know.
Again, I, as a physician, I always discuss trial options early in the decision-making process, ideally before exhausting all standard therapies because we know that the earlier you implement those novel therapies, the better it is, and the longer the remissions. Clinical trials not only provide access to novel treatments, but they also contribute to the future of cancer care.
And overall, patients should feel empowered to ask questions, always weigh pros and cons, and request a second opinion if they think that they need that.
