CAR T-cell therapy is a type of cellular therapy – a new, proven, leading-edge approach to immunotherapy available right here at the OSUCCC – James.
Called CAR-T for short, this living-drug therapy involves using a patient’s own white blood cells.
How? Specially trained James experts remove white blood cells (called T cells) from the patient’s blood, then in the lab, place what’s called a Chimeric Antigen Receptor (or CAR) on the cells’ surface to retrain them to identify a specific cancer-signal on that surface.
The specialists then infuse the CAR T-cells back into the patient, where these modified cancer-fighters target and attack only the cancerous cells. (Before specialists infuse the cells, patients undergo a round of chemotherapy to reduce their white blood cell count so the modified cells can be infused. Once infused, the CAR T-cells can recognize and destroy cancer cells.)
Extensive clinical trials have proven that CAR-T works quickly – and often with fewer side effects than traditional cancer treatments like chemotherapy and radiation. Patients have even described feeling these modified, retrained cells attack their cancer almost immediately after infusion, and many patients have experienced complete remission in a few months.
The world-renowned specialists at the OSUCCC – James believe the best way to treat patients and manage their disease successfully is to deliver the latest, most effective treatments available. Because these experts understand that cancer is complex, they use the most effective means of care to design the very best treatment plan – targeting each patient’s specific cancer – and offering improved outcomes, faster responses and fewer side effects.
There is no routine cancer, and every person’s disease is different, with individually unique genes and molecules driving that disorder. At the OSUCCC – James, our internationally recognized cancer specialists reach across medical disciplines to design the very best diagnostics, personalized treatment plan and therapies for each patient.
If you’ve been diagnosed with cancer, would like a second opinion or would like to speak with a cancer specialist about CAR-T or other cellular therapy options, please call The James Line at 800-293-5066 or 614-293-5066 to make an appointment. Specialized cell therapy coordinators are also available to answer questions at 614-688-7868.
After CAR T-cell therapy, patients will have follow-up appointments with the OSUCCC – James cell therapy team of experts as frequently as every month.
CAR T-cell therapy also requires coordination among several groups, including the clinical team, pharmacy and support care services. Because of the complex nature of treatment as well as potential side effects, patients who undergo CAR-T therapy must be closely monitored. This means patients stay in the hospital for at least seven days after CAR-T infusion.
Additionally, the OSUCCC – James specialists will schedule scans to assess progress at three months and again at six months, then the appointments will become less frequent as health improves and there are fewer signs of disease.
Patients may also find that things normally done on their own are not as easy or cannot be done as safely for a while after receiving CAR T-cell therapy. A caregiver can help patients get through this process by providing physical and emotional support.
If a patient was referred by a doctor outside of the OSUCCC – James, our team will coordinate with the referring doctor to transition care back to that physician at the appropriate time.
As with any cancer treatment, there are side effects that can be associated with CAR T-cell therapy, which is why all OSUCCC – James care team specialists are highly trained in the evaluation and treatment of side effects associated with this therapy.
While some can be serious, most patients experience moderate side effects, which are usually completely reversible.
The most severe side effect is cytokine release syndrome (CRS), which is a response to CAR T-cells attacking tumor cells and signaling to other immune cells to help. CRS can cause high fever and flu-like symptoms. Neurologic problems, including confusion, trouble finding words, tremors, trouble communicating and seizures also can happen and may be severe.
The OSUCCC – James Intensive Care Unity and The Wexner Medical Center Emergency Department work collaboratively with the Cellular Therapy Program when patient need care in those areas.
Some patients may have low blood counts or weakened immune systems. Additionally, some patients may need blood transfusions until their blood counts return to normal after treatment.
Other side effects include serious infections, low blood cell counts and a weakened immune system.
Side effects usually appear in the first week or two after infusion, which is why patients are closely monitored for the first seven days and continue to be monitored thereafter. It is possible to develop side effects later, which may require admission to the hospital for further monitoring and treatment. For monitoring purposes, patients must also be able to stay within a two-hour drive to the OSUCCC – James for the first four weeks after infusion.
Other side effects can include:
- Fever (100.4°F/38°C or higher)
- Difficulty breathing
- Chills or shaking chills
- Dizziness or lightheadedness
- Nausea, vomiting, or diarrhea which may be severe
- Fast or irregular heartbeat
- Fatigue or weakness which may be severe
Referrals and Appointments
The OSUCCC – James medical experts include world-renowned cancer specialists, subspecialists and super subspecialists in cancer prevention, detection, diagnosis and treatment.
To make an appointment (or as a provider, to refer a patient), please call The James Line at 614-293-5066 or 800-293-5066. The James Line is a free, confidential telephone service staffed by nurses to provide callers with cancer information and physician referrals.
Specialized cell therapy coordinators are also available to answer questions at 614-688-7868.
The James Cancer-Free World Podcast
CAR T-cell gene therapy is a new treatment with great promise. T cells from the body's immune system are removed, genetically altered to make them stronger and more efficient, and then put back in a patient's body, where they attack and kill cancer cells. Dr. Jaglowski describes the process and talks about her own cancer journey and how it changed her life.