CAR T-cell therapy is among the new immunotherapies that are proving to be the hottest area of cancer research. In CAR T-cell therapy, T cells are genetically engineered to attack a specific protein found on the surface of cancer cells. UCLA is one of the few centers that can deliver all FDA-approved CAR T-cell therapies.
If your doctor has suggested you receive CAR T-cell therapy or other engineered cell therapy, you are likely to have questions about what CAR T-cell therapy means to you. Here, our expert team answers the most frequently asked questions.
The Food and Drug Administration (FDA) approved CAR T-cell therapy in 2017 to treat two types of blood cancers: acute lymphoblastic leukemia (ALL), the most common childhood cancer, and diffuse large B-cell lymphoma, one of the most common non-Hodgkin lymphomas. Find out more about CAR T-cell therapy.
T cells are part of the adaptive immune system. These cells use a cell surface protein, called a T-cell receptor, to recognize and kill foreign invaders. They recognize bacterial, viral or fungal proteins.
Normally, you wouldn’t want T cells attacking your own body. In cases of cancer, we want them to attack cancer cells. Genetically modifying T cells to have a CAR, a chimeric antigen receptor, redirects T cells to recognize and kill cancer cells that we specify. Here is how it works:
CAR T-cell therapy was the first genetically engineered cell product to be approved for treatment of cancer. We can now treat patients with certain blood and bone marrow cancers who would otherwise have no good treatment options.
An even more exciting aspect is that we theorize that this technology could apply to other types of cancers. Researchers are investigating how to safely and effectively broaden this treatment. Many clinical trials are ongoing.
Researchers and doctors have found different rates of effectiveness. About one-third to half of patients have complete remissions (no cancer symptoms) that last two years or more after treatment. That success rate is a significant improvement over what we normally see for effective cancer therapies in patients who have exhausted standard options.
After CAR T-cell therapy, the vast majority of patients — more than 80 percent — have significant decrease in their cancer or go into a complete remission. And what’s very exciting to doctors is that the majority of people who go into a complete remission remain in that remission. It’s rare to have a new treatment that keeps people in long-term remission.
The FDA-approved treatment is for people with diffuse large B-cell lymphoma (DLBCL) who have not benefited from at least two types of standard treatment. Treatment also is approved for patients age 25 or younger with B-cell acute lymphoblastic leukemia (ALL) who have not benefited from at least two treatments.
We also have many clinical trials. CAR T cells might work in a variety of lymphomas and leukemias. If a patient has any type of leukemia or lymphoma, it is worth it to be evaluated for standard CAR T-cell therapy or clinical trials.
If the patient is determined to be a good candidate:
We hope we can use this approach for patients who have other kinds of cancers. Right now, there is promising data for CAR T-cell therapy in multiple myeloma and other types of lymphomas and leukemias. Even T-cell cancers have potential to be targeted by CAR T-cell therapy.
Solid tumors are a harder problem to solve with CAR T-cell therapy, but it is an area of active investigation. We believe we’ll see other indications down the road. There are patients with other cancers who will benefit from CAR T-cell therapy.
Bone marrow transplant (BMT), also called hematopoietic cell transplant, treats certain cancers or other diseases of blood and bone marrow. BMT involves taking healthy bone marrow stem cells (usually from a donor) and placing them in a patient’s bloodstream. After transplant, the healthy stem cells start making new cells to help rebuild a more robust immune system, free of cancer. Find out more about adult bone marrow transplant or pediatric bone marrow transplant.
For more information about CAR T-cell therapy at UCLA Health, please call 888-662-8252.