Merck16 Jan 2019 15:22
Interesting article this...An interview with Roger Perlmutter of Merck about immunotherapy... this is what he thinks of CAR T....might be why we have not seen Merck move in on that...
'RP: I love the CAR-T data in hematological malignancies. People’s lives have been saved, so that’s great. But to make this work, you’re going to have to treat solid tumors. And if you’re going to do solid tumors, you have to find a tumor-specific antigen to wipe out. Guess what? People have been looking for tumor-specific antigens for the last 50 years. We don’t have any.
The second problem is the industrialization of the process. Right now, with autologous transplant—we remove a blood sample from you, engineer it to kill your tumor cells, and in 14 days return the sample to you—the chain-of-custody issue becomes a big deal. Anybody who’s practiced medicine knows how often blood transfusions are mismatched. I hate to bet against American engineers, or any engineers for that matter, but the full-scale throughput for CAR-T is very small.
David Chang, who developed Yescarta [one of two FDA-approved CAR-T therapies] at Kite Pharma, and who used to work for me at Amgen, spent a lot of time talking to me about this. When Kite was acquired by Gilead [Sciences], the maximum throughput in their new facility was six patients a week. I’m not interested in treating six patients a week. I need to treat 100,000 patients. How am I going to do that?
The future for those kinds of therapies is tumor-specific antigens and allogeneic [‘off the shelf’] treatments, so you’ve got something in a bottle.'