Any quick comparison of how this more generalized CAR-T therapy might compare to the “push/pull” cancer fighting strategies that Nektar Therapeutics (NKTR) seems to be working on with NKTR-214 and NKTR-262, in particular.
To build on Ray’s post, there are two main differentiators between the push/pull and the CAR-T approaches.
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They will be for different indications. CAR-T has not been shown to be very effective for solid tumors yet. Yescarta and Kymriah are designed basically to compete against Rituxan. This may change as companies play around with what receptor to engineer, but for now, the strategies are in different spaces. The push/pull strategies, particularly what we will be seeing from Merck soon, will rely on intratumoral injections into solid tumors. With NKTR-214 and Opdivo, this combo may address tumors that are not easily accessible for intratumoral injection, like RCC.
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CAR-T will never be front-line or even second-line. This is primarily due to the cost, which is primarily due to the technical difficulty in the technique. Patient cells have to be extracted, purified, sorted, cultured, transduced, then reinfused back into the patient. That entire chain takes a lot of training and specialized expertise. I personally have done retroviral transfection on mouse cells - a technically easier feat - and there is a certain combination of science and art that is required in order to achieve consistent results.
Push/pull on the other hand has a good chance at being second line therapy. Technically, there is more space on the pricing because the drugs are more in line with “traditional” biologics.
Ted