Med City News published an article by Bruce Feinberg, M.D. at Cardinal Heath, examining CAR-T treatments and the impact they have had in medicine during the past five years. CAR-T’s footprint will continue to have an impact in the future.
Dr. Feinberg describes CAR-T as exciting and responsible for a shift in therapies for over ten thousand patients who have undergone treatment for blood malignancies like multiple myeloma.
The doctor points out that historically the focus has been on treating disease symptoms. For example, using H2 blockers for the prevention of acid indigestion, or using anti-inflammatories to ease the swelling and pain of arthritis. Dr. Feinberg notes that palliative treatments were developed in accordance with an age-old understanding of the way the body works.
The 21st-Century Approach
The new understanding developed in the 21st century focused on the genomic and molecular basis of a disease rather than simply easing the patient’s symptoms. The goal was to cure the illness.
According to Dr. Feinberg, clinicians now use targeted therapy that addresses the genetic and molecular flaws that allow cancer cells to thrive and the immune cells to ignore them.
CAR-T treatments are an excellent example of this type of therapy. The procedure has had a significant impact on healthcare and cancer treatment in particular.
About the Process
It has been five years since the FDA approved CAR-T cell therapy to treat mantle cell lymphoma. The process involved treating rare cancers by modifying the patient’s T cells. This may take several weeks.
The CAR-T cell therapy process functions as follows:
- Collect T-cells from the patient
- T-cells are modified to produce proteins (chimeric antigen receptors or CARs) on their surface
- Modified cells are infused back into the patient
- The cells then target and kill the cancer cells.
A simple definition is that CAR-T is a cell-based gene therapy involving the alteration of genes inside T-cells that assists in their attack on cancer.
About Cytokine Release Syndrome
The immune system goes on the attack against anything it considers to be “foreign invaders” CAR-T is not recognized by the immune system which can cause life-threatening side effects.
Cytokine release syndrome is the result of CAR-T cells multiplying and releasing chemicals called cytokines into the blood. The effect on the immune system causes severe side effects such as extremely high fever and difficulty breathing. Additional adverse events may include nausea, dizziness, rapid heartbeat, and muscle and joint pain.
The solution is to have the procedure given by specially trained staff and keep the patient under close surveillance for several weeks after receiving the therapy.
Looking Forward
More trials investigating CAR-T cell therapies are now being conducted in an effort to utilize the treatment for many other types of cancers.
