That was three years ago, and the cancer still hasn’ t returned. The CAR T – cell therapy success rate is about 30% to 40% for lasting remission, with no additional treatment , according to Michael Bishop, MD, director of UChicago Medicine’s cellular therapy program.
Currently, CAR T-cell therapy is FDA approved as standard of care for some forms of aggressive, relapsed or refractory non-Hodgkin lymphoma including diffuse large B cell lymphoma , primary mediastinal B-cell lymphoma , high grade B-cell lymphoma , transformed follicular lymphoma , and mantle cell lymphoma .
What are the side effects of CAR T-cell therapy? The most common side effects seen are: Cytokine release syndrome, which is similar to flu-like symptoms (headache; fever ; chills ; severe nausea, vomiting, diarrhea; severe muscle or joint pain), shortness of breath, low blood pressure and fast heart rate.
CAR T manufacturing, changes in tumor microenvironment, previous treatments or the effects of neighbouring cells can cause ‘ CAR T cell exhaustion’. Data indicate that ‘exhausted’ CAR T cells are not as proliferative or potent as their ‘non-exhausted’ counterparts.
Infusion: The infusion of CAR -T cells typically takes 30 to 90 minutes . However, plan for the infusion visit to take up to six hours to allow for care before and after the infusion.
By some estimates, CAR T-cell therapy can cost as much as $375,000 for a one-time treatment, depending upon the cancer type and treatment regimen. That estimate does not include hospital stays and other related expenses.
CAR – T clinical trials have shown huge remission rates, of up to 94%, in severe forms of blood cancer. This is particularly impressive considering most CAR – T clinical trials recruit cancer patients that have not responded to many if not all other available treatments .
Since the cells can persist in the body long – term , they will still recognize and attack cancer cells if and when there’s a relapse. The data is still evolving, but after 15 months, 42% of adult lymphoma patients who received CD19 CAR T – cell therapy were still in remission.
CAR T – cell therapy is only approved to treat two groups of people with certain types of cancer: Children and young adults up to age 25 with precursor B- cell acute lymphoblastic leukemia (ALL) that hasn’ t gotten better with treatment or that’s come back after treatment.
Other therapies you have, like chemotherapy , may work better if you also have immunotherapy . It causes fewer side effects than other treatments. This is because it targets just your immune system and not all the cells in your body. Your cancer may be less likely to return.
Medicare will cover CAR T – cell therapies when they are provided in healthcare facilities enrolled in the FDA risk evaluation and mitigation strategies (REMS) for FDA-approved indications (according to the FDA-approved label).
Chimeric antigen receptor ( CAR )- T cell therapy , also known as CAR – T cell therapy , was approved by the Food and Drug Administration in October 2017. CAR – T cell therapy is not the same as stem cell transplant or chemotherapy.
The most commonly observed CAR T – cell –associated toxicity is CRS. Fever is usually the first symptom of CRS. The time of onset of fever can be quite variable, ranging from a few hours to more than a week after CAR T – cell infusion.
CAR T – cell therapy , however, is different. It is a type of immunotherapy called “adoptive cell immunotherapy .” As ASCO President Bruce E. Johnson, MD, FASCO, describes it, this technique “allows clinicians to genetically reprogram patients’ own immune cells to find and attack cancer cells throughout the body.”
CAR – T cells are generated by the T cells from patients’ or donors’ blood. After the T cells are expanded and genetically modified, they are reinfused into the patients. However, many challenges still need to be resolved in order for this technology to gain widespread adoption.