CAR T Cell Therapy

Chimeric antigen receptor (CAR) T cell therapy is a type of cellular immunotherapy that changes T cells so they are able to recognize and attack cancer.

T cells are immune system cells that play several key roles in the body’s fight against disease. They help the immune system respond to disease and directly kill abnormal cells. Unfortunately, naturally occurring T cells in patients with cancer are not good at recognizing and fighting cancer cells.

CAR T cell therapy has been extremely effective in many patients. In some cases, the treatment has eliminated all signs of cancer.

However, CAR T cell therapy doesn’t work for every patient. Some have benefited for a short time before relapsing. Doctors are studying the reasons for these different responses.

How does CAR T cell therapy work?

Several CAR T cell therapies have been approved by the U.S. Food and Drug Administration (FDA). All approved products use T cells taken from the patient. Some clinical trials use T cells taken from donors.

In both cases, the T cells are sent to a lab. There, scientists genetically modify these cells to produce a protein (called a receptor) that recognizes another protein (called an antigen) on the surface of cancer cells. This recognition allows the modified T cells to identify and attack the cancer.

The modified T cells are multiplied by the hundreds of millions and then infused into the patient to fight the disease.

What cancers can be treated with CAR T cell therapy?

There are several different types of CAR T cell therapy produced by different drug companies. FDA-approved CAR T cell therapies treat the following diseases:

• B cell acute lymphoblastic leukemia for pediatric and adult patients
• Certain B cell lymphoma subtypes, including but not limited to:
  • high-grade B cell lymphoma
  • follicular lymphoma
  • primary mediastinal large B cell lymphoma
• Mantle cell lymphoma
• Multiple myeloma

MD Anderson is also conducting CAR T cell therapy clinical trials for a number of other cancers. These include additional subtypes of leukemia and lymphoma; multiple myeloma; and solid tumors such as breast cancer, lung cancer, pancreatic cancer and prostate cancer. Call our CAR therapy line at 833-368-6392 for information on CAR clinical trials.

What is CAR T cell therapy like for patients?

After the T cells are collected, modifying and multiplying them for infusion usually takes a few weeks. Patients may undergo other cancer treatments during this time.

When the CAR T cells are ready for use, they are sent to the hospital for infusion. Before infusion, patients are given a short course of chemotherapy. This weakens their existing immune system, giving the engineered T cells a better chance of expanding and fighting the cancer.

The infusion of the modified T cells is quick, typically lasting less than an hour.

After infusion, patients must remain near the hospital for at least four weeks. Depending on the patient’s type of cancer, condition and specific treatment, this time may be spent as an outpatient or a mix of both inpatient and outpatient. All patients must have a caregiver with them at all times to help care for them and monitor for side effects.

What are the side effects of CAR T cell therapy?

CAR T cell therapy’s side effects can range from mild to serious and even life-threatening if left untreated.

The most common side effect is low counts of immune system cells. This can lead to fever and infection. This is usually a mild side effect.

Other mild side effects include nausea, vomiting and diarrhea.

CAR T cell therapies can also have temporary but serious neurological effects, including confusion, slurred speech and seizures.

A potentially serious side effect is cytokine release syndrome (CRS). Cytokines are chemical messengers produced by T cells. They help organize the immune system’s fight against disease. In CRS, too many cytokines are produced.

CRS can be mild, with symptoms such as a fever. Some cases are serious, causing dangerously low blood pressure, difficulty breathing and/or organ failure. After infusion, doctors monitor for CRS and have effective treatments for patients who develop the condition.

While these are the known side effects, CAR T cell therapy is a new treatment and doctors are monitoring patients to uncover any long-term impacts of the treatment.

Other CAR therapies

CAR T cell therapy is the only CAR-based therapy that has been approved by the FDA. Others are in clinical trials. These include treatments that target more than one antigen on the surface of cancer cells and therapies that use natural killer (NK) cells (another type of immune system cell) instead of T cells. The treatment process and side effects for these therapies are similar to FDA-approved CAR T cell therapies.

Call our CAR therapy line at 833-368-6392 for information on CAR clinical trials.