Ted,
Following up on your comments, I think it is too early to say whether or not CAR-T will ever become first line. I agree it is incredibly expensive. If autologous CAR-T consistently delivers cures of previously uncurable blood cancers like lymphoma, leukemias, and myelomas it may be acceptable to insurers, patients, and clinicians in spite of cost. The more aggressive varieties of these might warrant first line treatment with CAR-T and the less agressive, due to requiring round after round of treatment, might also eventually be viewed as suitable candidates for CAR-t due to the cost of multiple rounds of treatment vs. “one and done”.
I believe one of the promises of allogenic CAR-T should be that it is cheaper as it would be “off the shelf” and presumably produced in larger quantities. If it combines cure and lower cost (than CAR-T) it seems like it could be a contender for first line therapy.
Dave