One of the newest, most promising treatments for blood cancer is chimeric antigen receptor (CAR)-T cell therapy. These therapies use your body's own immune system to help fight cancer.
Penn Medicine was a pioneer in the initial discovery of the first CAR T cell medications. We continue to advance the field by researching ways to develop more CAR T cell drugs and improve their use. We offer these cutting-edge treatments to patients who might benefit.
What is CAR T Cell Therapy?
CAR T cell therapy is a type of cancer immunotherapy treatment that uses immune cells called T cells that are genetically altered in a lab to enable them in locating in destroying cancer cells more effectively.
But, what diseases are treated with CAR T cell therapy? CAR T treatment can be very effective against some types of cancer, even when other treatments are not working. Currently, CAR T therapy is FDA-approved to treat several types of hematological malignancies, including:
How Does CAR T Cell Therapy Work?
T cells are white blood cells that find and fight illness and infection throughout the body. Each T cell has a receptor that can recognize antigens (proteins or molecules that are recognizable by the immune system). When the immune system recognizes foreign or abnormal antigens, it can work to destroy them.
But cancer cells sometimes have antigens that body doesn't recognize as abnormal. As a result, the immune system may not send T cells to fight cancer cells. In other cases, the T cells may not be able to clear the cancer cells.
Chimeric antigen receptor T cells are cells that are genetically engineered (changed) in a laboratory. They have a new receptor so they can bind to cancer cells and kill them.
Different types of cancer have different antigens. Each kind of CAR T cell therapy is made to fight a specific kind of cancer antigen. So a CAR T cell therapy made for one type of cancer won't work against another type of cancer.
The CAR T Therapy Process
CAR T cell therapy is a complex process that should be done by experts with extensive experience. Penn Medicine's Cell Therapy and Transplant Program will help you understand what to expect before, during and after the procedure.
The process takes a few weeks, and the steps generally include:
- Collecting the T Cells: We draw blood from a vein in your arm. The blood flows through a tube into an apheresis machine, which removes T cells. The machine returns the rest of the blood back into your body through a different tube.
- Engineering the T Cells: In a laboratory, scientists engineer the T cells by adding a manufactured CAR. Then the lab lets the CAR T cells multiply and grow.
- Infusing the CAR T Cells: Once the lab has enough CAR T cells, we inject them back into your arm. Your healthcare team might recommend chemotherapy before the CAR T cell infusion to help boost the treatment's effectiveness.
The process may take place in an outpatient infusion center or in the hospital.
Several CAR T cell therapies are approved by the U.S. Food and Drug Administration (FDA), and more are being developed. Penn researchers developed the first FDA-approved CAR T cell therapy for cancer, and we continue to lead and participate in several CAR T cell clinical trials.
CAR T Cell Therapy Side Effects
CAR T cell therapy may cause some side effects or complications. Our team will monitor you and educate you so you know what to look for.
A serious complication of CAR T cell therapy is cytokine release syndrome (CRS). CAR T cells may release chemicals called cytokines, which causes a reaction from the immune system. Your care team has specialized treatments to manage this complication. Signs and symptoms may include:
- Fever and chills
- Dizziness, lightheadedness or headaches
- Fatigue
- Pain in the muscles or joints
- Nausea, vomiting or diarrhea
- Rapid heartbeat
- Low blood pressure
- Difficulty breathing
CAR T therapy may also cause negative effects on the nervous system. Your care team can manage these complications with specialized treatments. These signs and symptoms may include:
- Confusion
- Tremors (shaking) or seizures
- Trouble speaking or understanding
- Loss of balance or consciousness
Other serious side effects that may require medical attention include:
- Abnormal levels of important minerals in the blood
- Allergic reactions
- Risk of infections, bruising or bleeding
CAR T Cell Therapy: The Penn Medicine Advantage
If you receive CAR T cell therapy through the Penn Medicine Blood Cancer Program, you'll find:
- Options for even the most complex patients: We offer the most advanced immunotherapy options. So we often help patients who may have had unsuccessful treatment elsewhere.
- Pioneering research: Penn was one of the first to develop CAR T cell therapies and continues to lead the field in research and clinical trials.
- Extensive experience: Our physicians and nurses have extensive experience with CAR T cell therapy. We understand what therapies can work in your individual case. And we can detect potential side effects and complications early for prompt intervention.
- Personal attention and education: Treatment decisions are complex and personal. Our physicians and nurse navigators will take time to educate you about the specific treatments that can help you and their risks. We'll answer any questions you may have and make sure you're prepared.
- Bloodless Treatment Options: For patients who decline blood products for any reason, we are one of the only Centers offering bloodless CAR T therapy. Learn more about our Center for Transfusion Free Medicine.
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