Helping Your Immune System Find Lymphoma
- CAR T-cell therapy reprograms immune cells to help them find and wipe out lymphoma
- It’s approved for people with aggressive B-cell lymphomas that have returned after treatment or didn’t respond to treatment
- Up to 40% of people can achieve long-term remission on CAR T-cell therapy
This process doesn’t always work as well as it should because cancer cells are good at evading detection. “They learn how to hide from our normal immune system and thereby be able to grow,” he says.
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CAR is short for chimeric antigen receptor. In CAR T-cell therapy, doctors remove white blood cells called T cells from your body, and then genetically engineer them so that they have a special protein called a chimeric antigen receptor on their surface. You’ll get a low dose of chemotherapy to prepare your body for the new T cells, which are multiplied into the millions before being returned to you. Once in your body, the receptor on the surface of the T cells seeks out and latches onto another protein on the surface of lymphoma cells. “Now the T cells can recognize the tumor, and the tumor can no longer hide from the patient’s immune system,” Dr. Jain says.Once the T cells do recognize the tumor, they eliminate it, no matter where it is. “The cells go around and attack the lymphoma,” he adds.
Are You a Good Candidate?
CAR T-cell therapy is approved for people with aggressive forms of B-cell lymphoma who either weren’t able to get an autologous stem cell transplant, or whose cancer returned (relapsed) after a stem cell transplant.
This includes people with:
- Diffuse large B-cell lymphoma
- Primary mediastinal B-cell lymphoma
- High-grade B-cell lymphoma
- Transformed follicular lymphoma
- Mantle cell lymphoma
If you have one of these cancers, talk to your doctor about whether CAR T-cell therapy is an option for you.
How Well Does it Work?
CAR T-cell therapy appears to be very effective so far. Because it’s a living drug, it lasts in the body long-term. That means it can continue to recognize and attack lymphoma cells whenever they start to grow again.
In people who meet the criteria and get CAR T-cell therapy, between 35% and 40% will have at least a two-year remission, “meaning that it has completely gone away and has not come back in any detectable form,” Dr. Jain says.
“We think this is quite exciting, because this was a patient population that, prior to CAR T-cell therapy, only about 6% of them ever had a complete remission. And the median overall survival is around 6 months,” he adds.
Just like any other cancer treatment, CAR T-cell therapy has potential side effects, and some of them can be serious. The modified immune cells can trigger the release of inflammatory substances called cytokines, which can cause fevers, weakness, and other flu-like symptoms. These symptoms are known collectively as cytokine release syndrome, or CRS. Most people who get CAR T-cell therapy will experience CRS, but it typically lasts for less than a week. It’s also possible for the treatment to affect your mind, causing confusion and difficulty speaking.
Have a discussion with your doctor about side effects, as well as the potential benefits of this treatment before you start on it, so you’ll know what to expect.
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