Dr. Wayne A. Marasco is a physician-scientist at Dana-Farber Cancer Institute and professor of medicine at Harvard Medical School.

Dr. Wayne A. Marasco

Enabling patients to generate CAR T-cells internally could cut kidney cancer therapy costs, explained Dr. Wayne Marasco of Dana-Farber Cancer Institute.

In Vivo CAR T-Cell Approach May Lower Kidney Cancer Treatment Cost

In vivo CAR T-cell therapy could drastically reduce the cost of treating kidney cancer by enabling patients to produce CAR T cells inside their own bodies, as explained by Dr. Wayne A. Marasco, a physician-scientist at Dana-Farber Cancer Institute and professor of medicine at Harvard Medical School, at the

Currently, CAR T-cell therapy involves collecting and modifying a patient’s cells outside the body—a complex process that drives costs up to $470,000 per patient.

Marasco noted that no CAR T-cell therapy has yet proven effective in renal cell carcinoma. He emphasized that researchers must first find an option that works, then focus on making it affordable and accessible.

What are some of the next steps necessary for further CAR T-cell research in renal cell carcinoma to advance more towards a cure, or just in general?

Well, I think we need to find a therapy that works, right? None of the ones I mentioned have made it to the headlines or had investigators and clinicians saying, “This is a win.” So, there’s still investigative work that has to be done.

In my opinion, there are two steps to this: one, finding something that works, and two, decreasing the costs. I don’t know if you or your audience are aware, but the six or seven FDA-approved CAR T-cell therapies are only approved for hematologic malignancies, either acute lymphoblastic leukemia or multiple myeloma. Those cost between $350,000 and $470,000 per patient. Now, that’s a one-time treatment, but it’s expensive.

So, once we find a therapy that works, the next step would be to reduce the cost dramatically to around $10,000 per patient. I think the way to do that would be to avoid all the ex vivo manufacturing that takes place right now to make the CAR T-cell product.

What we do now is we take a patient and we apherese them; in other words, we mobilize their white blood cells out of their blood, collect them, and use those cells to make the CAR T-cell product in the laboratory. That’s a very expensive process, but it could be reduced dramatically if we didn’t have to go that route by an order of magnitude or more.

So, when we find the appropriate CAR T-cell therapy, the next step would be, with further research we’re working on, to reduce the cost by delivering it in a different way. It would be the same product, but a different method of delivery where you don’t have to take cells out. Instead, you direct the therapy directly into the patient, where the CAR T cells are made in vivo — in the patient themselves — and then they can go to work without having to be taken out of the body, transduced, expanded, and then put back.

That whole ex vivo process adds huge costs of about $350,000 to $550,000 per patient. We could reduce that to probably around $10,000.

Transcript has been edited for clarity and conciseness

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Dr. Wayne A. Marasco

In Vivo CAR T-Cell Approach May Lower Kidney Cancer Treatment Cost

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