CAR T-cell Treatment

at SSM Health Saint Louis University Hospital

CAR T-cell therapy is not a pill, chemotherapy or stem cell transplant, but rather a type of immunotherapy that enhances T-cells to help the body fight cancer cells. T stands for a type of white blood cell called a T-cell, and CAR stands for chimeric antigen receptor. In CAR T-cell therapy, doctors extract a cancer patient’s own T-cells and reprogram them with CAR proteins, which are designed to detect and destroy cancer cells.

CAR T-cell therapy is a more efficient plan of treatment.

In the past, the only choices for patients with cancerous cells were chemotherapy, radiation, or a stem cell transplant. With the invention of “individualized” therapies like CAR T, patients may not need any other forms of treatment. Depending on the type of cancer, CAR T-cell therapy, and close monitoring by their doctors, may be the only treatment a patient needs and can result in long term remission in some patients.

How does CAR T-cell therapy work?

The process of CAR T-cell therapy can be described in several steps:

• The T-cells will be removed through a process called leukapheresis and collected into a bag
• The collected T-cells are then reprogrammed with CAR proteins
• A dose of chemotherapy, to suppress the immune system allowing expansion of the CAR T-cells once they are infused, is given to the patient
• Patient receives CAR T-cell therapy infusion
• Following infusion, the patient will be monitored for side effects
• Doctors will follow-up with the patient and additional testing will occur to determine the patient’s remission status

What are the side effects of CAR T-cell therapy?

Most CAR T-cell therapy patients do not experience side effects most commonly associated with chemotherapy, such as hair loss, nausea and vomiting. There are, however, risks of side effects with CAR T-cell therapy:

• Patients may exhibit flu-like symptoms: with high fever, chills, low blood pressure, or difficulty breathing – a condition known as Cytokine release syndrome (CRS)
• Patients undergoing CAR T-cell therapy may exhibit confusion, difficulty understanding language and speaking or other neurological difficulties

Patients are admitted to the hospital for several weeks so our care team can monitor response to the treatment and manage reactions to CAR T therapy. Complications are usually temporary, and our care teams are specially trained to identify and manage these side effects.

Who is eligibile for CAR T-cell therapy?

CAR T-cell therapy is not the right treatment for every patient. Your doctor will consider the type of cancer, past treatments and your overall health before recommending CAR T-cell therapy.

CAR T-cell therapy is only approved to treat two groups of people with certain types of cancer:

• Children and young adults up to age 25 with acute lymphoblastic leukemia (ALL) that hasn’t improved with or has returned after treatment
• Adults with aggressive large B-cell lymphoma that hasn’t improved with or has returned after treatment

SLUCare Physican Group offers CAR T-cell therapy at SSM Health Saint Louis University Hospital and SSM Health Cardinal Glennon Children's Hospital. If you think you are a candidate for CAR T-cell therapy, ask your physician for a referral or call us.