Well, good news for me, anyway.
As many of you know, there's been an explosion in recent years of what are called CAR-T treatments for blood cancers in general and for multiple myeloma in particular. Unlike ordinary chemo treatments, CAR-T involves taking T cells from a patient (e.g., me) and shipping them off to a lab where they undergo genetic magic and are then infused back into the patient. It's a one-time treatment and shows considerable promise as an almost complete cure.¹
There are a bunch of CAR-T treatments being developed, but the one I've been following most closely has been a Chinese version licensed in the US by Johnson & Johnson. Today, it received its final FDA clearance:
The Food and Drug Administration on Monday cleared the therapy, named Carvykti, for the treatment of multiple myeloma in adult patients whose disease has worsened despite prior treatments with other drugs.
....In one of J&J’s U.S. studies, about 98% of the 97 multiple-myeloma patients treated with Carvykti had a significant reduction in the proteins that signal the presence of myeloma, and 83% had a complete remission, indicating no detectable cancer cells, at a median of 22 months after treatment.
Joseph Mikhael, chief medical officer of the International Myeloma Foundation, said the effectiveness demonstrated in the study was “really unprecedented. That’s why there’s so much excitement around it.”
This is obviously good news for me, but it's not unalloyed. First of all, CAR-T treatments have potentially serious side effects, though they're short-term and mostly seem to be quite controllable these days. Second, CAR-T treatments are typically given to patients who are at the end of their rope, which doesn't describe me. However, even with some risk involved, I'd rather try this while I'm still relatively healthy since I suspect the treatment is more effective the healthier you are. Third, CAR-T therapies cost about half a million bucks.
All that said, I'm going to push my oncologist to see what it takes for me to qualify for this. I don't expect anything immediate, but it would be nice to get approved for this within the next year or so.
¹In the blood cancer world, terminology is confusing. "Complete remission" doesn't actually mean complete remission. It means "cancer levels are so low they're undetectable." That's pretty good! But there are still a few cancerous cells roaming around that will probably make a comeback eventually.
My wife works for the director of oncology at Washington University, where they are on the bleeding edge of CAR-T therapies. For a few blood cancers, CAR-T has proven to be transformative, even curative. If I had multiple myeloma, I'd run, not walk, to the nearest CAR-T trial. Good luck, Kevin!
I was tangentially involved on the development of the first CAR-T drug, and yes, it's roughly tantamount to a "vaccine for cancer," in that the cancer may never go away completely, but any that does stick its head up gets clobbered pretty quickly. The downsides, apart from expense and extreme specificity, are -- or were at the time -- overreaction of the immune system in the early phases, roughly similar to a fatal allergic reaction to a bee sting. I don't know how things have evolved, nor anything about the J&J product, but I'd say yeah, go for it.
They have significantly improved the CAR-T payload to help prevent the cytokine release syndrome seen in the early trials. Still happens, but much less prevalent and also more treatable.
Also tangentially involved in early research in this at a biotech. Highly recommending treatment as well!
The upfront cost of treatment has to be compared to the cost of long-term palliative care.
Something people tend to overlook when bemoaning the high costs of some therapies.
FWIW, payers (insurance companies and Medicare/Medicaid in the US, mostly governments elsewhere) look VERY closely at that: it's called "cost effectiveness," and it is often a major basis for prices set by drug development companies.
Rationally, quite so.
But as I am sure you are well aware, profit margins tend to be influential, and well as politics.
Consider the various reactions to the successful development of nothing less than an effective cure for Hep-C.
Several major insurers blanched at the price tag, given the potential large patient population, and suggested that they would only pay for treatments for those who were symptomatic, i.e wait until they were clearly sick.
And then the issue of paying heavily for incarcerated patients - a fairly high percentage of those infected with Hep-C - that wasn't exactly a popular political notion.
Congratulation on the good news and good luck with getting approved for the treatment.
That's great to hear!
Hope they lower the qualifications or at least provide exceptions. I understand why they leave it as a last resort, but still, I think most ppl would take that risk.
Yay!
Our collective good wishes!
Yes, this is good news for us Mm vets. I signed up for a trial back in 2018. I wrote about it on my blog: https://goodbloodbadblood.com/2018/12/10/the-university-of-cancer-part-4/
For reasons unknown, I was not chosen to participate. Nonetheless, I have stayed informed while working my way through the latest options, in particular Daratumumab with either Velcade or Revlimid.
Recently, I had my MM re-staged as Dara was losing its effectiveness. Car-T is still an option especially now that the FDA is on board. 👏 I am 75, casually relapsing, and depending on how I react to KPd treatment, I may still consider pursuing Car-T.
Good luck to you!
I was assured that the chines could contribute no sicence but were just takers. /sarc
I mean, they've got about 1/5th of the world's medical researchers, so...
(I do wonder, though, if Kevin has fully thought through the risk of having CCP nanobots circulating in his bloodstream.)
He's prolly given that as much thought as he gave his decision to back Warren over Bernie in the 2020 Democrat primary.
Considering Bernie would have given Kevin cost free Medicare4All to cover the half-mil CAR-T treatment, I hope he knows he made the wrong choice. & that choice was definitely worse than Chinese 6G being given entree to his human temple.
Awesome to hear!! You’re a good guy and deserve a long and happy life
This is terrific news.
Sounds promising. Best of luck.
Do it Do it Do it Do it Do it Do it Do it Do it!!!
Half a mil? It can be done.
With Medicare4All, sure.
But not with our current zero coverage Obummercare flimflam.
I hope you get it.
Fingers crossed!!
This is great news, Kevin!
Wow, Vreat News. Wish you nothing but the best.
Great. What good is spellcheck?
That's good news indeed. You've been holding up pretty well, as far as I can tell, so even if you're not immediately approved for treatment, it's good to know that there is efficacious treatment available when either you or it is ready. Good luck!
Good news indeed! Even better once you can get it! All the best!
What he said!
Or she. Or... you get the idea.
Good news for your readers, too!
When I saw something about CAR-T, I had to wrestle with myself not to post it here. Thanks for rewarding my self-control! I hope the treatment is available to you soon.
What ever is available, we are pulling for you Kevin.
If this has received final FDA approval, you should be eligible to receive the treatment, but you might have to come up with the money yourself.
Pingback: Health Update – Kevin Drum