CAR-T cell therapy is an individualized cell-based technique that involves removing some of your own white blood cells, including T cells. To make CAR-T cells, the collected T cells are genetically treated in the lab to produce special receptors called chimeric antigen receptors, or CARs. These CARs allow the T cells to recognize an antigen (or marker) at the surface of cancer cells and activate T cells' ability to kill these cancer cells. The CAR-T cells are infused back into your body to identify and destroy certain cancers. This immunotherapy is one of the most promising areas of cancer treatment.
The FDA-approved conditions for CAR-T cell therapy include:
- B-cell precursor acute lymphoblastic leukemia (ALL), in people up to 25 years of age
- Diffuse large B-cell lymphoma (DLBCL)
- Primary mediastinal large B-cell lymphoma
- Large B-cell lymphoma transformed from follicular lymphoma
- High grade B-cell lymphoma
- Aggressive B-cell lymphoma not otherwise specified (NOS)
People who have relapsed or refractory disease may be eligible for CAR-T cell therapy.
Possible side effects
Most people have a reaction to CAR-T cells that requires them to stay in the hospital for days to weeks for monitoring and management. Typically, the reaction happens within hours to days after the infusion. Side effects may include:
- Low blood counts from the conditioning chemotherapy
- Cytokine release syndrome (CRS), which causes a fever, fast heart rate, low blood pressure and low blood oxygen
- Neurologic effects known as neurotoxicity, which can cause confusion, tremors or difficulty with communication
Side effects are generally reversible. Your care team will talk with you about how to monitor for reactions. The long-term toxicity of CAR-T cell therapy is still being studied. Talk with your doctor about the potential risks of treatment.
Oct. 23, 2018
- Locke FL, et al. Clinical and biologic covariates of outcomes in zuma-1: A pivotal trial of axicabtagene ciloleucel (AXI-CEL; KTE-C19) in patients with refractory aggressive non-Hodgkin lymphoma (NHL). Presentation. 2017 annual meeting of European Hematology Association, June 24, 2017, Madrid, Spain. https://learningcenter.ehaweb.org/eha/2017/22nd/181753/yi.lin.clinical.and.biologic.covariates.of.outcomes.in.zuma-1.a.pivotal.trial.html?f=m3. Accessed Oct. 27, 2017.
- Neelapu SS, et al. Chimeric antigen receptor T-cell therapy: Assessment and management of toxicities. Nature Reviews Clinical Oncology. 2018;15:47.
CAR-T Cell Therapy Program