Your Questions About CAR-T Therapy Answered

Chimeric antigen receptor (CAR) T therapy is front and center in the explosion of cell and gene therapies that have transformed the treatment of cancer in the last decade. Lehigh Valley Topper Cancer Institute, part of the NCI Designated Sidney Kimmel Comprehensive Cancer Center at Jefferson Health, is the only location in the region offering the treatment through a generous donation from local residents Tom and Karin Hall.

Usama Gergis, MD, MBA, Director of Stem Cell Transplant and Cellular Therapy (TCT) and Professor of Oncology at the Sidney Kimmel Medical College at Thomas Jefferson University, oversees the program, including at Lehigh Valley Health Network (LVHN). In Dr. Gergis’ words, “CAR-T will revolutionize cancer treatment in our region and improve the lives of countless patients.”

To help patients and others understand CAR-T therapy and how it impacts our options here in the Lehigh Valley, Dr. Gergis offered to answer a few questions.

Dr. Gergis: CAR-T therapy is specifically for treatment of blood cancers such as B-cell acute lymphoblastic leukemia (ALL), multiple myeloma and certain types of non-Hodgkin lymphoma. In addition to their diagnosis, potential CAR-T patients must undergo a complete workup to ensure they can tolerate the treatment, and that they have sufficient social support to go through the treatment process.

Dr. Gergis: I would not characterize the treatment as a last resort; however, our patients are those who, in general, have not responded to first-line treatments or have had treatments such as chemotherapy and the cancer has returned.

Dr. Gergis: Not at all. The beauty of CAR-T therapy is that it uses the patient’s own cells to destroy the cancer. The process starts with clinicians collecting the patient’s T cells – those that fight viral infection and cancer – in a one-day, intravenous procedure. The T cells are then separated from the blood and sent to a lab where chimeric antigen receptor proteins are added. These proteins act like a navigation system for the T cells to track down and kill cancer cells. The protein-enhanced cells are multiplied in the lab and then reinfused back into the patient’s vein in another intravenous procedure.

Dr. Gergis: Research says that any patient who qualifies and is healthy enough for CAR-T therapy can receive it. Age alone is not a barrier. A patient in their 70s with common conditions such as hypertension and diabetes may still be eligible. My oldest CAR-T patient is 86 years old.

Dr. Gergis: It does not. Typically, patients spend approximately seven days in the hospital. For select, fit patients who have adequate family support, we can do the whole procedure in the outpatient setting.

Dr. Gergis: Studies and our real-world expereince have shown that CAR-T cell therapy can achieve complete remissions in a significant portion of patients with relapsed or refractory blood cancers. For example, one study in diffuse large B-cell lymphoma found a 76.6% response rate and a 55.3% complete remission rate.