Seeking comment on the methods used in this study, where the authors conclude as shown in bulleted key points below.
As a patient advocate I am not qualified to critique the methods or conclusion but have read other articles (I will post later) indicating that fractional doses of CAR t-cells over 3 days can reduce the risk of CRS (cytokine release syndrome) and that use of steroids to treat CRS does limit the efficacy of CAR tell therapy. This concern is also based on the known inhibitory effect of steroids on immune cells (they are used to treat lymphoma).
My reading of it is that this was not a controlled study and the size of it was very small. My concern is that the acceptance of it as a convincing finding is limiting the study of alternative dosing schedules of CAR t-cells that could improve both patient safety (literally save lives) and improve the efficacy of the treatment.
Early intervention with tocilizumab and steroids does not impact the expansion or persistence of SCRI-CAR19v1 CAR T cells in B-ALL.
Administration of tocilizumab and corticosteroids does not negatively impact the efficacy of SCRI-CAR19v1.