There’s a rapid expansion going on in CAR T cell therapy, the remarkable “living drug” treatment that involves genetically engineering a patient’s own immune cells to fight cancer.
As of right now, CAR T cell therapy is approved by the U.S. Food and Drug Administration (FDA) for widespread use in:
- Diffuse large B-cell lymphoma (DLBCL), the most common type of non-Hodgkin lymphoma; and
- Young adults with acute lymphoblastic leukemia who have not had success treating their cancers with standard therapies.
Clinical trials — which the FDA requires before it can approve a treatment — are abundant in CAR T cell therapy. At Dr. Ganguly’s cancer center alone, he shares that at this moment there are 38 different trials taking place.
How Do I Find and Enroll in a Clinical Trial for CAR T Cell Therapy?
Because CAR T cell therapy is a highly specialized, intense procedure, it’s important to discuss the possibility of a referral with your oncologist.
“When a patient is diagnosed with difficult-to-control lymphoma [for example], they should be referred to a center that is equipped with cellular therapeutics and technology,” Dr. Ganguly says, adding that, right now at least, most of these specialized centers are located at academic institutions.
If your oncologist gives you a referral to one of these specialized centers, you will then meet with a cellular therapeutics specialist to discuss the next steps.
Why Can’t I Get CAR T Cell Therapy at Any Cancer Center?
CAR T cell therapy is a highly technical treatment that carries the risk of several serious side effects, which explains why it requires a team of specialized professionals to administer.
“I’d say a village is required to take care of one patient [undergoing CAR T cell therapy],” Dr. Ganguly says, adding that in his own institution, this “village” or team of specialists is collectively referred to as a “CAR T hub.” The team of specialists includes, among others:
- Physicians
- Nurses
- Nurse practitioners
- Pharmacists
- Financial counselors
- Social workers
“So it’s a big team approach where holistically we take care of the patients and we take them through the whole process of identification to insurance approval … trial accrual, collection of the cells,” Dr. Ganguly says. “And then post-treatment, taking care of the patient is also vitally important.”
How Common are These Specialized CAR T Cell Centers?
Originally, Dr. Ganguly says, there were only 16 centers in the country that had the expertise and experience to administer CAR T cell therapy. Now, however, that number is expanding.
“With the explosion of CAR T, more and more centers are now involved in cellular therapeutics,” he says. “But we have a lot of work to do. There are a lot of patients that could benefit from this novel, exciting technology. But the knowledge is very important.”
The knowledge that Dr. Ganguly references — meaning the awareness that CAR T cell therapy is even an option in the first place, and the know-how needed to find a center offering it — is not always a given. That’s why specialists are working hard to bring this knowledge to community oncologists.
“We need to go to the grassroots,” he says. “We need to go to community oncologists and educate and talk about this technology so that the patients who are in dire need of this technique should be promptly referred.”
With CAR T Cell Therapy, ‘Time is Of the Essence’
The types of cancers that can benefit from CAR T cell therapy are often aggressive, fast-growing cancers, making it extremely important that oncologists refer their patients promptly in the cases where CAR T cell therapy is an option.
“These cancers don’t wait,” Dr. Ganguly says. “They grow exponentially, and sometimes, if we cannot get them on time, then the CAR T cannot be manufactured, and valuable time may be lost.”
The importance of timing with CAR T cell therapy occasionally prompts patients to consider the option even before they need it, so that if and when they do need it, they will have access right away.
“Sometimes, I have seen patients who do not even need CAR T right now, but [are] on the waiting list in case the disease does not respond to the standard-of-care treatment,” Dr. Ganguly says. This way, he adds, the patients are “already in the system so the referring doctor picks up the phone and we get them quickly, and we get the CAR T hub activated, and we transition the patient through the whole process.”
Learn more about SurvivorNet's rigorous medical review process.
