How many CAR-T’s do we need to test drive? Save

There were 93 abstracts with CAR-T in title at #EULAR2026! Additionally, there was an excellent review (WIN) by Dr. Hector Chinoy. We know lots but have more questions.

Who should we select for Rx:
Activity high, low damage, haven’t failed much Rx, but poor prognosis?

Do we want to inhibit:
a CD19, CD20, BCMA, NK, duo, etc
Armored CAR (CD19 + cytokine inhibition to enhance durability of response)
Which target to choose?

Do we prime with chemo after leukapheresis?

What type of CAR?
Autologous
Allogeneic – Off the shelf – less cost, less delay, guessing if this is appropriate CAR for an individual pt, ?’rejection’ (Graft vs. host ?theoretical)
Endogenous (in vivo with mRNA or viral delivery)

Safety short and long term – timing of reactions
Cytokine release syndrome (CRS)/ Immune Effector Cell-Associated Neurotoxicity Syndrome (ICANS)
Local Immune Effector Cell-Associated Toxicity Syndrome (LICATS)

What to do if there is a recurrence? Re-Rx with CAR-T vs. conventional Rx
How long will they work for? A few years? Likely NOT forever (my guess).

What type of cell deplete CAR to select in different SARD diseases - Unknown

Immune reset vs immune dimming
Concept of NOT a cure but a vast improvement and then easier to treat disease. There is more data to come!