What is CAR-T (Chimeric Antigen Receptor T-cell) therapy?

How to Explain CAR-T Therapy to Patients

CAR-T therapy is a revolutionary "living drug" treatment where we take your own immune cells (T cells), genetically reprogram them in a laboratory to recognize and attack your cancer, multiply them by millions, and then infuse them back into your body to hunt down and destroy cancer cells. 1, 2

What Happens to Your Cells

• We start by collecting your white blood cells through a process called leukapheresis, similar to donating blood but taking longer (2-4 hours) 2
• Your T cells are sent to a specialized laboratory where scientists genetically modify them to express a special receptor (called a CAR) that acts like a GPS system to find cancer cells 1
• These modified cells are grown and multiplied into millions of cancer-fighting cells over several weeks 2, 3
• The cells are frozen and shipped back to your hospital when ready 2

The Treatment Process

• Before receiving your CAR-T cells back, you'll receive chemotherapy for a few days to prepare your body (called lymphodepletion) - this helps the CAR-T cells work better 2
• The CAR-T cells are infused back into your bloodstream through an IV, similar to a blood transfusion 2
• Once inside your body, these engineered cells multiply further and begin attacking cancer cells that display the target protein (usually CD19 for blood cancers or BCMA for multiple myeloma) 1, 2, 4

What to Expect After Treatment

• You will need to stay near the hospital (within 2 hours) for at least 4 weeks after the infusion for close monitoring 1, 2
• You cannot drive or operate machinery for at least 8 weeks after treatment 1
• Your medical team will check your blood work, vital signs every 8 hours, and perform neurological assessments at least twice daily during the critical period 2

Potential Side Effects You Should Know About

• Cytokine Release Syndrome (CRS) occurs in 40-95% of patients and happens when your CAR-T cells release large amounts of inflammatory chemicals as they fight cancer 1, 4

  • Symptoms include high fever, low blood pressure, difficulty breathing, and rapid heart rate 1
  • This typically starts within days of infusion and is usually reversible with medications like tocilizumab 1
  • Almost half of patients require intensive care monitoring for these toxicities 1

• Neurological problems (CRES) can occur in 15-65% of patients, appearing 1-2 weeks after infusion (sometimes up to a month later) 1, 2, 4

  • Symptoms include confusion, difficulty speaking, seizures, or rarely brain swelling 1
  • These effects are generally reversible but require immediate medical attention 1

Why This Treatment Is Different

• Unlike chemotherapy that you receive repeatedly, CAR-T is typically a one-time treatment 2, 4
• The cells continue living and working in your body for months to years, providing ongoing cancer surveillance 1, 2
• This therapy has achieved remarkable results: up to 90% response rates in certain leukemias and improved survival in lymphomas (54.6% alive at 4 years versus 46% with standard treatment) 1, 4
• For multiple myeloma, CAR-T extended the time without disease progression to 13.3 months compared to 4.4 months with standard therapy 4

Important Limitations to Understand

• This is currently only FDA-approved for certain blood cancers (leukemias, lymphomas, and multiple myeloma), not solid tumors 1, 2, 4
• The manufacturing process takes several weeks, so this isn't an immediate treatment option 2, 5
• Your cancer must express the specific target protein (like CD19 or BCMA) for the therapy to work 1, 2
• There's a risk your cancer cells could lose the target protein and escape detection 3, 6

What Makes You a Candidate

• You typically need to have cancer that has come back after other treatments or hasn't responded to standard therapies 1, 4
• You must be healthy enough to undergo the treatment and manage potential side effects 1
• Your cancer cells must test positive for the target antigen (CD19 for most blood cancers, BCMA for myeloma) 1, 2