Abstract
Chimeric antigen receptor T cell therapy (CAR-T) is potentially lifesaving for many patients with a variety of malignancies. Unlike most other treatment, CAR-T cells grow in vivo and may persist to provide long term disease control. Understanding the kinetics of their expansion and how this correlates with responses and toxicity has provided interesting insights into this form of therapy. In this review, correlations between cell kinetics, response and toxicity are discussed together with strategies being evaluated to reduce morbidity. The long-term impact on disease control of glucocorticosteroids or cyclophosphamide used in patients who develop neurologic toxicity are at present unclear. Whether the CAR-T cells have to persist for a cure is also a concept that needs further study.