What is Yescarta?
Yescarta is a type of cellular therapy called CAR T-cell therapy. CAR T-cell therapy uses specially altered T cells – a part of your immune system – to fight cancer. A sample of a patient’s T cells are collected from the blood, then modified to produce
special structures called chimeric antigen receptors (CARs) on their surface. When these CAR T cells are reinfused into the patient, the new receptors enable them to latch onto a specific antigen on the patient’s tumor cells and kill them. Learn more
about how CAR T-cell therapy works.
The clinical trials of Yescarta, in which DF/BWCC was the only participant in northeast site, showed that 82% of patients with treatment-resistant or relapsed aggressive non-Hodgkin lymphoma responded to the CAR T-cell therapy, including 54% who had a
complete response (i.e. no sign of cancer).
Who is eligible to receive Yescarta?
The FDA has approved Yescarta for use in adult patients with a diagnosis of DLBCL, primary mediastinal B cell lymphoma, high grade B-cell lymphoma, or DLBCL arising from follicular lymphoma that has either not responded to, or relapsed after, second or
greater lines of systemic therapy. Therapy must have included a CD20 antibody and an anthracycline.
As a first step, ask your oncologist for a referral to DF/BWCC’s Adult Lymphoma Program to determine if Yescarta is an appropriate approach to your care. All patients must have a physician referral. Call us at 877-801-CART (2278) or email us at email@example.com.
Where is Yescarta available?
Because this is a highly specialized and highly personalized treatment, Yescarta will be available at a limited number of specialized cancer centers initially. DF/BWCC is an authorized center for Yescarta.
How can I find out if I am eligible to receive Yescarta?
Ask your oncologist for a referral to a specialist in the DF/BWCC Adult Lymphoma Program for an evaluation to determine if you meet the medical
eligibility criteria for this treatment. Call us at 877-801-CART (2278) or email us at firstname.lastname@example.org.
Will my insurance cover this new treatment?
Health insurers are actively engaged in preparing their coverage policies for this treatment. In the meantime, coverage will be reviewed on a case-by-case basis as is typical when new therapies are first approved. We will do everything we can to seek
health insurance coverage for clinically-eligible patients.
What are the anticipated side effects?
There are risks of significant side effects with CAR T-cell therapy. In some patients, CAR T cells can initiate a massive release of substances called cytokines, which triggers an inflammatory condition known as cytokine-release syndrome (CRS). Symptoms
may be flu-like, with a high fever and/or chills; low blood pressure; difficulty breathing; or confusion. These symptoms can be mild or severe. Patients may also experience neurologic challenges such as difficulty understanding language and speaking.
Patients are admitted to the hospital for several weeks so our care team can monitor response to the treatment, and manage reactions to this therapy. The complications are generally temporary and resolve with treatment. Our care team is specially trained
to identify and manage these side effects.
What if Yescarta isn’t appropriate for me? What are my other options?
Another option may be to participate in a clinical trial. At DF/BWCC, our lymphoma program offers a wide range of clinical trials exploring several new treatment options. This includes other CAR T-cell therapy trials as well as other forms of immunotherapy.
We will work with you to determine if a clinical trial may be an appropriate treatment option.
Is CAR T-cell therapy used to treat other types of cancer?
Right now, the FDA has approved CAR T-cell therapy for adult patients with certain types of lymphoma and for children with acute lymphoblastic leukemia that haven’t responded to other forms of treatment. Clinical trials of CAR T-cell therapy are underway at DF/BWCC for other types of blood cancer and researchers are beginning to explore CAR T-cell therapy for solid tumors.
What is the treatment process for patients?
There is a multi-step process to evaluate and prepare a patient for Yescarta treatment.
- Evaluation: Patients will undergo a series of tests and screenings at DF/BWCC to determine if Yescarta is an appropriate treatment option.
- Collection: T cells are collected from patients via apheresis, a process that withdraws blood from the body and removes one or more blood components (such as plasma, platelets or white blood cells). The remaining blood is then returned
into the body. The apheresis process takes place at the Kraft Family Blood Donor Center at Dana-Farber Cancer Institute and Brigham and Women’s Hospital.
- Engineering: The T cells are sent to a drug manufacturing laboratory where they are genetically engineered to express chimeric antigen receptors (CARs) on their surface. CARs are proteins that allow the T cells to recognize an antigen
on targeted tumor cells.
Multiplication: The genetically modified T cells are “expanded” by growing cells in the manufacturing laboratory until there are many millions of them. The process of engineering and growing sufficient quantities of CAR T cells
can take a few weeks. When there are enough of them, the CAR T cells are frozen and sent to the hospital or center where the patient is being treated. At our center, these cells are returned and processed at Dana-Farber’s Connell and O’Reilly
Families Cell Manipulation Core Facility.
- Conditioning Therapy: Prior to infusion of the CAR T cells, patients may receive chemotherapy for their cancer.
- Infusion: Soon after completion of chemotherapy, the patient is admitted to the hospital and the CAR T cells are re-infused into the patient’s bloodstream in a process similar to a blood transfusion. This is a one-time infusion, though
patients may remain in the hospital for several weeks to monitor response to treatment, overall condition, and side effects.
- Recovery: Patients who receive CAR T cell therapy have a risk/recovery period of approx. 2-3 months. During this period, patients will be evaluated for side effects and treatment response. It is not uncommon for patients to be re-admitted
to the hospital during this period to manage complications from treatment. During this period, patients need to remain close to DF/BWCC for regular follow-up care. A resource specialist can assist in arranging for a place to stay during this time,