CAR T-Cell Therapy

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CAR T-cell therapy is a type of immunotherapy, which is medication that enhances the ability of a patient’s immune system to attack cancer cells.

It can be an option for adults with lymphoma that hasn’t responded to traditional chemotherapy and children and young adults with acute lymphoblastic leukemia.

UT Southwestern Medical Center was the first in Texas to offer CAR T-cell therapy to treat advanced cancer and our program is the largest in the region.

Expertise in CAR T-Cell Therapy for Advanced Cancer

T-cells’ function in the immune system is to destroy abnormal or infected cells, such as viruses and cancer. In some patients, T-cells cannot detect or destroy cancer cells, or there are not enough T-cells. CAR T-cell therapy genetically modifies T-cells so they can better detect, target, and destroy cancer cells.

The U.S. Food and Drug Administration (FDA) has approved a number of CAR T-cell therapy products for specific types of blood cancers:

  • Certain types of large B-cell lymphoma, the most common type of non-Hodgkin lymphoma in adults, that have come back or have not responded to at least two previous types of treatment
  • A type of acute lymphoblastic leukemia in patients up to age 25 that has not responded to treatment or has come back after successful treatment at least twice
  • Relapsed refractory multiple myeloma

Research and clinical trials are ongoing to develop CAR T-cell therapies to treat:

  • Acute myelogenous leukemia (AML)
  • Chronic lymphocytic leukemia
  • Solid tumors, such as osteosarcoma
  • Other types of lymphoma

UT Southwestern’s cancer physicians and their experienced teams are dedicated to exceptional care, backed by the latest research, to provide the best possible results for our patients.

Innovation and Experience

We have experience in CAR T-cell therapy that few medical centers can match.

  • We treat the second most number of pediatric patients in the world using Kymriah, an FDA-approved treatment for acute lymphoblastic leukemia (ALL).
  • Cancer researchers at UT Southwestern took part in clinical trials for CAR T-cell therapy for a type of leukemia; we were one of only 13 centers in the U.S. and the only one in the region to do so.
  • We were one of a few U.S. medical centers participating in a clinical trial for the most advanced CAR T-cell therapy for multiple myeloma, known as BB2121.
  • UT Southwestern Pediatric Group was one of 25 sites for the Novartis-sponsored ELIANA study, which was the first global clinical trial of CAR T-cell therapy for the treatment of refractory/relapsed ALL in pediatric patients.

As the only National Cancer Institute (NCI)-designated comprehensive cancer center in North Texas, we deliver the best cancer care available today and push to discover new treatments. NCI designation means we offer patients the ability to participate in the broadest possible range of clinical trials, with access to potential therapies not available at other facilities.

Treatment with CAR T-Cell Therapy

Our cancer specialists evaluate patients to determine whether they qualify for CAR T-cell therapy. The treatment process, which typically takes 12 to 16 weeks, has several steps:

  1. Blood collection: Our doctors begin by drawing blood from the patient. The blood is processed to separate some T-cells, and the remaining blood is returned to the patient.
  2. Genetic alteration of the T-cells: In a special laboratory, doctors genetically modify the T-cells using a disarmed virus. The T-cells produce molecules on their surface known as chimeric antigen receptors (CARs). Doctors then culture the new CAR T-cells so that they multiply into the millions. This process can take several weeks.
  3. Chemotherapy: The patient receives a brief regimen of chemotherapy to deplete certain immune cells that might attack the new T-cells.
  4. Infusion: The patient receives the new T-cells in an infusion procedure and typically stays in the hospital for one to two weeks.

The genetically modified cells continue to multiply in the patient’s body as they circulate through the bloodstream. The new T-cells recognize and attach to a specific antigen (protein) on cancer cells, enabling the T-cells to destroy the cancer cells.

Potential Side Effects of CAR T-Cell Therapy

It is important for patients to receive CAR T-cell therapy from an expert team of cancer specialists at a facility like UT Southwestern. Our cancer doctors have the necessary experience, gained through our participation in clinical trials, to monitor patients for side effects such as:

  • Cytokine release syndrome, an inflammatory reaction that produces symptoms ranging from mild and flu-like (fever, nausea, headache) to serious and life-threatening
  • Low red blood cell count (anemia)
  • Low white blood cell count (neutropenia)

Clinical Trials

As a medical research institution, UT Southwestern frequently conducts a wide variety of cancer clinical trials, giving our patients access to the newest treatments. Patients should speak with their doctors about the availability of clinical trials.