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Expert Discusses Challenges of Using CAR T-Cell Therapy to Treat Diffuse Large B-Cell Lymphoma

By David G. Maloney, MD, PhD
General Discussions - Discussions
11 replies

At the 2019 School of Hematological Oncology, OncLive®, a sister publication of Oncology Nursing News®, sat down with David G. Maloney, MD, PhD, medical director of cellular immunotherapy at the Immunotherapy Integrated Research Center at the Fred Hutchinson Cancer Research Center, to discuss recent challenges in using CAR T-cell therapy for patients with diffuse large B-cell lymphoma.


The biggest issue we're facing right now is we need to get patients earlier in their treatment course. If you just analyze some of their results with ZUMA-1, which was using axicabtagene ciloleucel, or Yescarta, in that setting the patients who were in the lowest quartile of tumor burden had very high overall response rates, but they also had durable remission. So, their chance of being in remission was quite a bit higher at 1 year compared to the quartile that had the highest degree of tumor burden.

At the same time, those patients have less toxicity. They have less serious cytokine release syndrome and less serious neurologic toxicity. So just by trying to find patients earlier before they failed every possible option or even getting the patients into better disease response before, they come to CAR T cells can greatly improve the outcome.  
By Arthurnib
Oct 01, 2019 11:58:44 am
Can I find my love online? The sleeping Fox catches no chickens. You can't fish a fish out of a pond easily. All these Proverbs we know since childhood. Have you ever seriously thought about the application of folk wisdom to life? It always seemed to me that these sayings and jokes are invented by grandmothers in the villages for fun, but this was exactly until I realized how vital they are. First there were exams at school, dance class, after entering the Institute, accordingly, diploma, work... And all you had to exercise patience, diligence, spend a lot of time and effort. But I could not imagine that relationships with men also need to be approached, as they say, seriously. It would seem that so many friends, a big company, and cafes/clubs/restaurants are not the worst place to meet. But I had no luck. The a cheapskate, then ham, then a liar and so on. There were, of course, and decent fans, but still one does not cling. I had just found a job. I took my job search seriously — I got up every day in the morning and during the day, with a break for lunch, I worked at the computer, called, sent resumes, arranged interviews. In short, my job was to find a job. When I thought about relationships, I realized-why am I sure that Prince charming will fall from the sky right on my head? What makes me think that without any effort I will have what I want — even if it is intangible? Of course, I perform, so to speak, a minimum — I bring myself in order in the morning, try to dress stylishly, watch my hair and nails. But this is clearly not enough. Having decided on my desires (and I wanted something more serious and conscious than just running to the movies and walking in the parks), I set to "work". To start "accidentally" told everyone I know that I'm finding — they planted a few candidates. Then we with friends have become regularly walk in club. But! For myself, I realized — the club is not the best place to meet. Why? First, very noisy, second, dark, third, all "a bit" under shafe. So if you want seriousness, the club disappears by itself. The options were few — either the Internet or wait for the mercy of lady Luck and look out for the Prince at bus stops, in shops, cafes and so on. But I am a person who is not used to sit idly by, so I turned to the Internet. Actually, I used the same principle as when looking for a job, except that I did not get up early, and, I must admit, it is more pleasant to look through the profiles of nice guys than vacancies. The girlfriend reacted to the surprise consensus — fuuu! How could you! Internet Dating is awful, the Internet is one maniacs and anxious. Frustrated and ashamed, I was about to wrap up my campaign to find a mate, but first decided to consult with an old friend. "What's wrong with that? "what is it?" he asked. "The Internet is only one way, so why should you turn it down?" Because of the opinions of others? Are they married or paired?"At that time, indeed, most of my friends were single. So I decided not remove its held and to continue the search, but not advertise this. Indeed, maniacs and not quite sane young people-more than enough, but normal guys who know the lessons of politeness, too, there were many! In General, in the first few messages you can understand — adequate person or not. I met some interesting people, and we became friends with some of them. I was amazed at how many well-mannered, educated, affluent guys meet on the Internet. it Turned out, now this well acceptable way to familiarity for busy people. As one of my new fans said, you can find absolutely beautiful things in the most unexpected places. And really, I think every girl has ever been on a total sale in a clothing store. Oh, chaos! By the middle of the day, the store workers can not cope-and here and there there are huge, I'm not afraid of the word, piles of clothes. I somehow hated to rummage in these piled things, like the store, and you feel in the market, as my friend says-a dung beetle. But once in such a dump, I managed to pick up an absolutely stunning dress! So, returning to the folk wisdom, it is not a place that makes a man, but a man a place. And the Internet is no exception. When my friends found out about my "operation Y", they did not laugh — next to me was a beautiful man. Although, perhaps, the word "turned out" is not suitable, because our couple was formed as a result of active searches for each other. Discard your prejudices, friends also ceased to disdain the Internet that ultimately resulted in two weddings where I was lucky enough to visit! Of course, I'm not saying that the Internet is the perfect place to meet and find your soul mate, no, this is only one of the possible options. And if you decided to approach this problem with all seriousness, then why deprive yourself of additional opportunities to solve the problem? Importantly understand, that, first, immediately, this second, relations not will appear, the search for-no easy labor. Moreover, the relations themselves are not a continuous holiday, but, again, the result of the efforts made and compromises reached. Think about whether you want to sacrifice something, starting with your time and effort and ending with something more, such as giving up a job or a favorite hobby, in favor of the family. Therefore, having defined the desires, it remains only to act, because we-women - can afford to do several things at the same time and, so it happened historically — to make efforts, one way or another, is also our path, whether it is directly your actions or coordination and delegation. Go for it! and hopefully the fish you manage to fish out will be Golden. Personally I tried my Luck here: - Link4you
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