Scenarios: • Car-T second line succeeds Pros: • If it works there’s no (autologous) bone marrow transplant needed. • 85% success (verify!) • This is all this lab does • clinical trials require very close monitoring – I guess there’s a lower chance I’d get lost in the shuffle
• really cool; I would have more fun than at Kaiser. • Also since it’s new I would be helping future people (which is partial BS because I’m doing this for me and helping others in this case isn’t a motivation) • Paid for by kaiser. Apparently CAR-T is in the neighborhood of $0.5M, not cheap.
Cons: • 1-2% chance of death (but not really a ‘con’ since apparently that risk exists either way, just different) • This trial is still Phase I which is a safety trial and completion isn’t slated for 15 years. I’m
assuming that’s because they’re tracking folks over the long term but still, seems very early. Related to this unknown future recurrence. Also the fact that CD19 and CD22 weren’t on my pathology report is somewhat concerning since those are the main targets. Cells lacking those targets could potentially still grow from what I think I understand. • Untested vs. a known quantity with many years of data • unknown long-term outcomes • cytokine storm; neurotoxicity; other?
What would you do? III Uncertainty The chemo didn’t cure me.