What is CAR T-Cell Therapy?

For many people diagnosed with blood cancer, treatments such as chemotherapy and stem cell transplantation can successfully control the disease. For others, however, cancer may stop responding to these treatments or it may return.

CAR T-cell therapy has emerged in recent years as one of the most promising advances in cancer treatment, offering hope to people with blood cancers such as certain types of leukemia, lymphoma and multiple myeloma. The innovative treatment uses the body’s own immune system to recognize and attack cancer cells.

What is CAR T-cell therapy and how does it work?

CAR T-cell therapy, also called CAR T cell therapy, CAR-T therapy or CART therapy, is a type of immunotherapy. This means it uses your own immune system to fight cancer.

The personalized cell therapy begins with the collection of T cells, a type of white blood cell, from the patient’s blood. These cells are then sent to a laboratory where they are modified so that they can recognize specific proteins that are found on cancer cells. The cells are then returned to the patient’s body via an intravenous (IV) infusion.

However, the treatment is more than a single infusion. From assessment and cell collection through to laboratory preparation and specialist monitoring, the process requires careful coordination by an experienced, multidisciplinary team.

Unlike chemotherapy, which works while the medicine is active in your body, CAR T-cells continue to work after treatment is given, so it is often referred to as a ‘living treatment’.

Which blood cancers can be treated with CAR T-cell therapy?

At the moment, CAR T-cell therapy is used to treat the following types of blood cancer:

• Acute lymphoblastic leukemia (ALL)
• Chronic lymphocytic leukemia (CLL)
• Follicular lymphoma
• Large B-cell lymphoma
• Mantle cell lymphoma
• Multiple myeloma

Research is ongoing into whether it may one day be used to treat solid cancers.

What happens during CAR T-cell therapy?

CAR T-cell therapy is delivered as a single infusion, but treatment usually takes place over several weeks and involves a number of specialists.

• The first step is to determine whether the therapy is suitable for the type of cancer you have, and your overall health.
• T cells are then collected from your blood.
• The T cells are then genetically modified in a specialist laboratory.
• The modified T cells are returned to your bloodstream via infusion, where they begin to recognize and attack cancer cells.
• You will remain under close observation to monitor for side effects.

What happens if CAR T-cell therapy fails?

CAR T-cell therapy has improved outcomes for many patients, but it’s important to remember that it won’t work for everyone. If this is the case, your cancer care team will discuss all available options with you, based on your individual circumstances.

Is CAR T-cell therapy safe?

Like all treatments, CAR T-cell therapy is associated with certain side effects.

The most significant include cytokine release syndrome (CRS) and neurological complications. These range in severity, which is why careful monitoring after treatment is so important.

Thanks to advances in patient selection, supportive care and the early recognition of complications, the safety of CAR T-cell therapy has improved and many side effects can be managed effectively.

What are the symptoms of blood cancer?

Recognizing the early signs of blood cancer is important. Common leukemia symptoms include persistent fatigue, unexplained bruising, frequent infections, fever and bone pain.

Common lymphoma symptoms include swollen lymph nodes, unexplained weight loss, night sweats, fever and itching.

Multiple myeloma can cause bone pain, frequent infections, fatigue and kidney problems.

Of course, these symptoms don’t always mean that blood cancer is present, but if they are ongoing, they should always be evaluated by a doctor.

Blood cancer treatment – looking ahead

CAR T-cell therapy represents a significant advancement in cancer treatment. By using the patient’s own immune system to fight cancer, it is offering new hope to those living with certain types of leukemia, lymphoma and multiple myeloma whose cancer has returned or isn’t responding to other treatments.

As research continues, doctors hope that CAR T-cell therapy will one day be used to treat other blood cancers and, eventually, certain solid tumors.