Choosing the Best Treatment for You
- These days, many cancer patients come to their appointments well-informed about the latest treatment options. For non-Hodgkin lymphomas, that may involve immune therapies.
- CAR T-cell therapy and bispecific antibodies are providing a lot of hope when it comes to treating b-cell lymphomas.
- CAR T-cell therapy involves training a person’s own immune cells to target and attack cancer cells.
- Bispecific therapies bind to two antigens at once. One arm of the treatment binds to the cancer cell and attacks it directly, while the other attaches to a “killer” immune cell called a T-cell, and pulls it toward the lymphoma cell.
- Access to cancer centers, caregiving, and disease specific features should all be considered when deciding between the treatment options.
Dr. Loretta Nastoupil, an oncologist at the University of Texas MD Anderson Cancer Center, tells SurvivorNet that many patients in modern times are doing a great job with researching their options — but they can still be overwhelming.
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Dr. Nastoupil says that for patients who progress within a year of treatment, CAR T-cell therapy will likely be considered. CAR T-cell therapy involves training a person’s own immune cells to target and attack cancer cells. “For second-line patients, those that progress within a year of their frontline treatment, yes, we’re trying to get them to CAR T-cell therapy as quickly as we can,” she says. “For patients who … progress after CAR, bispecific antibodies are, in my opinion, the most effective and exciting treatment options we have. Fortunately, they’re now FDA approved.”Bispecific therapies bind to two antigens at once. One arm of the treatment binds to the cancer cell and attacks it directly. Meanwhile, the other arm attaches to a “killer” immune cell called a T-cell, and pulls it toward the lymphoma cell. Ultimately, the cancer gets attacked on two fronts.
Not everyone will be eligible for these innovative treatments, though, Dr. Nastoupil points out — and CAR T-cell therapy isn’t always the choice after cancer returns.
For CAR T-cell therapy, it’s important to consider the following factors that may affect whether you can get the treatment:
- Access (there are geographic regions in the U.S. where there are a lack of centers that can provide CAR T-cell therapy)
- Caregiving (after CAR T-cell therapy, a patients needs to have a caregiver with them 24 hours a day for four weeks)
- Disease-specific features (patients shouldn’t begin CAR T-cell therapy with disease that is rapidly progressing)
Dr. Nastoupil adds that due to factors such as the above, there are definitely situations where she’d recommend a bispecific antibody over CAR T-cell therapy.
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