CAR-T CELL THERAPY
CAR-T CELL THERAPY
Arming your body to battle cancer
Chimeric antigen receptor T-cell (CAR T) therapy is a type of immunotherapy. It’s a gene therapy that uses your body’s own T cells - certain white blood cells often called the “workhorses” of the immune system-to attack cancer cells.
The U.S. Food and Drug Administration (FDA) has approved CAR-T cell therapy to treat certain kinds of non-Hodgkin’s lymphoma and leukemia that have not responded to other types of treatment. The FDA based its approval on positive results in clinical trials, with many patients responding to the treatment and even achieving complete remission.
Blood is taken from a vein in your arm through an intravenous line (IV). It flows through a tube to a machine that removes certain cells and sends the rest of the blood back into your body. This process can take a few hours, and you can usually go home afterward.
Your T cells are separated from the other cells and sent to a laboratory, where they are genetically modified to produce tiny molecules on their surface called receptors. The receptors enable the T cells to recognize a specific protein, or antigen, on cancer cells. The CAR-T cells multiply in the lab until they number in the millions. Preparing your T cells in the lab can take a few weeks.
Before you receive your specially treated T cells, you will need three days of low-dose chemotherapy to prepare your body. Then the cells will be infused into your body through an IV. This one-time process takes about 30 minutes.
In your body, the CAR-T cells reproduce and attack the cancer cells. While your body is responding, you may not feel well. You’ll probably stay in the hospital for several days. After you leave, you’ll still need to be closely monitored for the next four weeks or so. Our team will track how well the treatment is working and help you deal with any side effects.
Currently, CAR-T cell therapy is FDA-approved only for patients with certain kinds of non-Hodgkin’s lymphoma or leukemia, and only for those patients who have been through at least two other approved treatments. At Penn State Cancer Institute, we’re using it to treat certain kinds of lymphoma in adults. If you’ve been treated at least twice, and your lymphoma either did not respond or relapsed, you may qualify for this treatment.
The types of lymphoma that can be treated with CAR-T cell therapy include:
- Diffuse large B-cell lymphoma (DLBCL)
- Primary mediastinal large B-cell lymphoma
- High-grade B-cell lymphoma
- DLBCL arising from follicular lymphoma
CAR-T cell therapy is not approved for primary central nervous system lymphoma.
Q: I think I may qualify for CAR-T cell therapy. What should I do?
A: Talk to your doctor about a referral to Penn State Cancer Institute, or call 833-531-CART (2278).
Q: What happens next?
A: We’ll meet with you to talk about the treatment, what to expect and how to take care of yourself afterward. We’ll do an evaluation and ask you questions about your medical and family history, any medicines you’re already taking and other factors. If we agree that you qualify and may benefit from CAR-T cell therapy, we’ll create the treatment plan and begin scheduling appointments.
Q: What are the side effects of CAR-T cell therapy?
A: Like other cancer treatments, CAR-T cell therapy can have serious side effects, including:
- High fever
- Extreme fatigue
- Low blood pressure
- Fast heartbeat
- Difficulty speaking or slurred speech
You may also be at a higher risk for infections, a low blood cell count and other complications. That’s why it’s especially important to keep all your follow-up appointments and to let your health care team know about any symptoms you may have.
Q: What can I expect after treatment?
A: You’ll probably stay in the hospital for several days after your infusion of CAR-T cells. Then you’ll need to stay near the hospital for about four weeks so you can come in for monitoring and treatment of side effects. You’ll need to refrain from driving for several weeks.
The good news: many patients in clinical trials had positive results. Nearly 40 percent of lymphoma patients achieved complete remission, which means tests showed no signs of cancer. About half had no response. No one can say for sure whether CAR-T cell therapy will work in your specific case, or whether you will have lymphoma or some other cancer again. Research is still ongoing to better determine which patients will respond to therapy and to assess and manage long-term effects and side effects.
Q: Will insurance cover CAR-T cell therapy?
A: Most insurers will cover it on a case-by-case basis. Medicare and Medicaid will cover it in some cases. We’ll talk to you about finances before we begin.
Q: Will this therapy be used to treat other kinds of cancer?
A: Research is ongoing and promising. CAR-T cell therapy for other types of cancer is being tested in clinical trials. Also, CAR-T cell therapy is a type of immunotherapy, and other types of immunotherapy are being studied to treat cancer and other diseases. Penn State Cancer Institute is committed to this search for answers and new knowledge. Find out more about clinical trials at Penn State Cancer Institute.
Q: How can I find out more about CAR-T cell therapy?