RegMedNet answers some of the most frequently asked questions about CAR-T therapy.
Chimeric antigen receptor (CAR) T-cell therapy is a relatively new kind of blood cancer treatment that uses the immune system to kill cancer cells. In some cases, has cured patients where other treatments have failed. As CAR-T cells stay active in the body for a long period of time, the therapy can be effective as a one-time treatment, differentiating it from many other blood cancer drugs.
Here, RegMedNet explains how patients receive CAR-T therapy, the side effects that can occur, the safety and efficacy of the treatment, and the therapies that are currently available.
How Do Patients Receive CAR-T Therapy?
CAR-T therapy comprises four stages, so the process can take several weeks to complete.
- First, a clinician removes some T cells — blood cells that protect against infection — from the patient’s bloodstream through a process called apheresis. This process involves circulating the patient’s blood through a machine to filter out the T cells and return the rest of the blood to the patient. This can take two to three hours.
- Then, a laboratory team genetically modifies the T cells to make them into CAR-T cells, which are more efficient at identifying and killing cancer cells. This process can take a few weeks.
- Once the lab team has modified the cells, a clinician returns the cells to the patient’s bloodstream via a drip to fight cancer. This takes a few hours.
- Once the patient has completed the CAR-T therapy, hospital staff closely monitor them in case any side effects arise.
What Side Effects Can CAR-T Therapy Cause?
CAR-T therapy can cause some serious side effects. Therefore, patients only receive the treatment in specialist hospitals, where an expert team can manage these effects if they occur. The most common side effects are:
- Cytokine release syndrome (CRS): This syndrome may occur when CAR-T cells release cytokine, a substance that can trigger an immune reaction in the body. This immune reaction can be similar to severe infection and manifest in flu-like symptoms. Specialists can usually treat CRS within a few days. However, the syndrome can become dangerous and cause symptoms like difficulty breathing, high fever, low blood pressure, and fast heart rate. CRS occurs in more than 1 in 10 patients.
- Neurological side effects: CAR-T therapy can also trigger side effects like delirium, agitation, seizures, confusion, difficulty speaking or understanding, altered or decreased consciousness, and loss of balance. However, these symptoms usually respond to steroids or get better on their own.
Is CAR-T Therapy Safe?
The CAR-T treatments that have been approved for use in the UK have been through in-depth studies to ensure they’re as safe as possible. That said, as CAR-T therapy is a relatively new treatment, it is not yet clear whether there are any long-term risks. However, each clinical study that examines the therapy reveals more insights into how to make it more effective.
Is CAR-T Therapy Effective?
CAR-T treatments offered in the UK have a better track record of getting patients into remission than other treatments. However, the evidence of this success is limited to studies that have tested the therapy on specific groups of patients. It isn’t yet clear whether the therapy is effective in large numbers of patients or how well it targets many types and stages of blood cancer.
How Can I Get CAR-T Therapy?
There are currently three types of CAR-T therapy in use in the UK for eligible patients who have multiple myeloma, diffuse large B-cell lymphoma (DLBCL), mantle cell lymphoma, follicular lymphoma, or B-cell acute lymphoblastic leukemia (ALL). Some patients receive these treatments on the :
- Tecartus (brexucabtagene autoleucel)
- Yescarta (axicabtagene ciloleucel)
- Kymriah (tisagenlecleucel).
Meanwhile, various other CAR-T treatments are undergoing research in clinical studies. These studies are as possible treatments for leukemias, lymphomas, and myeloma.
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