FDA Maintains Support for CAR T-cell Therapies Despite Safety Concerns
The move comes amid heightened FDA focus on CAR T-cell therapy safety and benefit-risk balance. In a New England Journal of Medicine commentary published in January, Peter Marks, MD, PhD, former director of the FDA’s Center for Biologics Evaluation and Research (CBER), and Nicole Verdun, MD, former director of CBER’s Office of Therapeutic Products, acknowledged that although CAR T-cell therapies offer substantial clinical benefit, their safety profiles require ongoing vigilance.2
“The demonstrated efficacy of the current generation of approved CAR T products comes along with several well-described safety concerns that are noted in the products’ labeling, including risks of cytokine release syndrome, immune effector cell–associated neurotoxicity syndrome, various forms of cytopenia, and hypogammaglobulinemia,” they wrote, in the commentary. “Better understanding of some of these risks has led to improved outcomes, such as for patients who develop cytokine release syndrome.”2
Currently Approved CAR T-cell Therapies in the United States
Including Breyanzi and Abecma, six CAR T-cell therapies have received FDA approval to date. These include:
Kymriah (tisagenlecleucel): For B-cell acute lymphoblastic leukemia (ALL) and B-cell non-Hodgkin lymphoma (NHL)
Yescarta (axicabtagene ciloleucel): For NHL and follicular lymphoma
Tecartus (brexucabtagene autoleucel): For mantle cell lymphoma and ALL
Carvykti (ciltacabtagene autoleucel): For MM.2
Patient Advocates Welcome Reduced Burden
"Living with blood cancer is challenging, but patients and their loved ones still need to maintain jobs, take care of families, and plan for the future,” said Sally Werner, CEO, Cancer Support Community, in the press release. “Today’s announcement reduces some of the most onerous requirements that may have previously discouraged patients, particularly those who live far from a treatment center, from seeking the potentially transformational effects of cell therapy. We applaud any and all efforts to continue to break down barriers, reduce time burden on patients and caregivers, and increase uptake of this life-saving therapy."
References
U.S. Food and Drug Administration Approves Streamlined Patient Monitoring Requirements and Removal of REMS Programs within Bristol Myers Squibb’s Cell Therapy Labels. BMS. June 26, 2025. Accessed June 27, 2025. https://news.bms.com/news/details/2025/U-S--Food-and-Drug-Administration-Approves-Streamlined-Patient-Monitoring-Requirements-and-Removal-of-REMS-Programs-within-Bristol-Myers-Squibbs-Cell-Therapy-Labels/default.aspx
FDA Urges Caution Following Boxed Warning Requirements on CAR T-Cell Therapies. PharmExec. January 25, 2025. Accessed June 27, 2025. https://www.pharmexec.com/view/fda-urges-caution-following-boxed-warning-requirements-on-car-t-cell-therapies