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CAR T-cell Therapy

  • What it is

    Chimeric antigen receptor, or CAR T-cell therapy, is a new form of cell therapy that uses specially altered T cells to more specifically target cancer cells. Currently, it is approved by the FDA for some forms of refractory non-Hodgkin lymphoma, and pediatric relapsed acute lymphoblastic leukemia (ALL), and is available through clinical trials for other forms of blood cancer.

    How it works

    CAR T-cell therapy illustration

    The immune system is made up of specific cells and organs that protect the body from infection and cancer. Among these are T cells, which hunt down and destroy abnormal cells, including cancer cells.

    After a sample of a patient's T cells has been collected from the blood, the cells are re-engineered so they sprout special structures called chimeric antigen receptors (CARs) on their surface. When these CAR T cells are reinjected into the patient, the receptors may help the T cells identify and attack cancer cells throughout the body.

    T cells are collected by a process called apheresis. From a needle in the patient's arm, blood flows through a tube and into an apheresis machine, which separates out the T cells and returns the rest of the blood cells to the other arm. The procedure is done in one day in a clinic at the Kraft Family Blood Donor Center at Dana-Farber Cancer Institute and Brigham and Women's Hospital.

    The collected cells are genetically engineered, at Dana-Farber or a special lab, to produce the CAR protein. They are then prepared for infusion back into the patient. The process of engineering the cells and producing sufficient quantities of them can take a few weeks. In the meantime, patients may receive chemotherapy for their cancer.

    When the CAR T cells are ready, patients are admitted either to Dana-Farber's Inpatient Hospital located within Brigham and Women's Hospital (BWH) or to BWH, where the cells are infused in a process similar to a blood transfusion, usually preceded by several days of preparative chemotherapy. During this time, patients may get medications to prevent and control possible side effects of the newly-engineered cells. At this time, patients need to stay in the hospital for a few days or even several weeks, depending on their condition and the risk of side effects.

    Throughout the entire process, careful measures are in place to ensure patients' safety.

  • CAR T-Cell Therapy: How Does It Work?
    CAR T-cell therapy, like all forms of cancer immunotherapy, seeks to sharpen and strengthen the immune system’s inherent cancer-fighting powers. It involves treating patients with modified versions of their own immune system T cells ­– white blood cells that help protect the body from disease.

  • As a new approach to cancer treatment, CAR T-cell therapy is being tested in clinical trials for a wide variety of tumor types. Although these trials are ongoing and the results are very preliminary, the best results to date have been obtained in blood cancers such as lymphoma and leukemia.

    At DF/BWCC, clinical trials of CAR T-cell therapy are now underway for several different types of cancer. Trials are also in progress involving other types of T cell therapies. Speak with your care team for more information about cellular therapy clinical trials.

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  • Dr. Caron Jacobson on CAR T-cell Therapy Data
    Dana-Farber’s Caron Jacobson, MD, provides an update on the promising, long-term data presented on CAR T-cell therapy for non-Hodgkin lymphoma, multiple myeloma, and acute lymphoblastic leukemia.

  • Pediatric CAR T-cell Therapy

    Dana-Farber/Boston Children's is a certified treatment center for providing the recently FDA-approved CAR T-cell therapy called KYMRIAH to patients who are up to 25 years old with second or later relapsed or refractory B-cell acute lymphoblastic leukemia (ALL).