Health

Car T Cell Therapy

February 24, 2023
Jessica Anderson

CAR T cell therapy is a type of immunotherapy that uses genetically modified T cells to attack cancer cells in the body. T cells are a type of immune cell that can recognize and kill infected or abnormal cells.

You Will Learn:

  • How Car T Cell Therapy Works
  • Car T Cell Therapy Process
  • Car T Cell Therapy Developing Companies
  • Car T Cell Therapy for Lymphoma
  • Car T Cell Therapy for Multiple Myeloma
  • Car T Cell Therapy Side Effects

How Car T Cell Therapy Works

CAR T cell therapy involves taking T cells from a patient’s blood, modifying them in a laboratory to produce chimeric antigen receptors (CARs) that can target specific proteins on cancer cells, and then infusing the modified cells back into the patient’s body.

Once the modified T cells are reintroduced, they multiply and attack cancer cells that express the targeted protein. CAR T cell therapy has been particularly successful in treating certain types of blood cancers, such as leukemia and lymphoma.

Although CAR T cell therapy is a promising treatment, it is not without risks. The therapy can cause side effects such as fever, low blood pressure, and neurological symptoms. In some cases, these side effects can be severe and require hospitalization. Additionally, the long-term effects of CAR T cell therapy are not yet fully understood, and further research is needed to determine its safety and effectiveness in treating other types of cancer.

Car T Cell Therapy Process

CAR T cell therapy is a complex process that involves several steps, including:

  1. Collection of T cells: The first step in the CAR T cell therapy process is to collect T cells from the patient’s blood through a process called leukapheresis. During this procedure, a machine separates white blood cells, including T cells, from the rest of the blood components.
  2. Genetic modification of T cells: The collected T cells are sent to a laboratory, where they are genetically modified to express CARs that can recognize and bind to specific proteins on the surface of cancer cells.
  3. Expansion of CAR T cells: The modified T cells are cultured and allowed to multiply in the laboratory, resulting in a large number of CAR T cells.
  4. Conditioning chemotherapy: Before the CAR T cells can be infused back into the patient, they may undergo a conditioning chemotherapy regimen to prepare the body for the infusion and to clear out any remaining cancer cells.
  5. Infusion of CAR T cells: Once the patient has completed the conditioning regimen, the CAR T cells are infused back into the patient’s bloodstream via a vein.
  6. Monitoring and follow-up: After the infusion, the patient is closely monitored for any side effects and to assess the response to the therapy. Additional follow-up visits and monitoring are typically required to assess the long-term effectiveness of the treatment.

Car T Cell Therapy Companies

There are several companies that are actively involved in developing and commercializing CAR T cell therapies. Some of the prominent companies in this field include:

  1. Novartis: Novartis was the first company to receive FDA approval for a CAR T cell therapy in 2017. The therapy, called Kymriah, is used to treat certain types of leukemia and lymphoma.
  2. Gilead Sciences/Kite Pharma: Gilead Sciences acquired Kite Pharma in 2017, which has developed a CAR T cell therapy called Yescarta for the treatment of certain types of lymphoma.
  3. Bristol Myers Squibb: Bristol Myers Squibb acquired Celgene in 2019, which has developed a CAR T cell therapy called Breyanzi for the treatment of certain types of lymphoma.
  4. Juno Therapeutics: Juno Therapeutics was acquired by Celgene in 2018, and has developed a CAR T cell therapy called JCAR017 for the treatment of certain types of lymphoma.
  5. Bluebird Bio: Bluebird Bio is developing several CAR T cell therapies for the treatment of different types of cancer, including bb2121 for multiple myeloma and bb21217 for solid tumors.
  6. Autolus Therapeutics: Autolus Therapeutics is developing several CAR T cell therapies for the treatment of different types of blood cancers, including AUTO1 for acute lymphoblastic leukemia and AUTO3 for diffuse large B-cell lymphoma.
  7. Legend Biotech: Legend Biotech is developing several CAR T cell therapies for the treatment of different types of blood cancers, including ciltacabtagene autoleucel (cilta-cel) for multiple myeloma.

Note that this list is not exhaustive and there are several other companies that are also working on developing CAR T cell therapies.

Car T Cell Therapy for Lymphoma

CAR T cell therapy has shown promising results in the treatment of certain types of lymphoma. In particular, two therapies have been approved by the FDA for the treatment of lymphoma:

  1. Yescarta (axicabtagene ciloleucel): Yescarta is a CAR T cell therapy that is approved for the treatment of certain types of non-Hodgkin lymphoma (NHL), including diffuse large B-cell lymphoma (DLBCL) and primary mediastinal large B-cell lymphoma (PMBCL). In clinical trials, Yescarta has demonstrated high response rates and durable remissions in patients with relapsed or refractory NHL.
  2. Breyanzi (lisocabtagene maraleucel): Breyanzi is another CAR T cell therapy that is approved for the treatment of certain types of relapsed or refractory NHL, including DLBCL. In clinical trials, Breyanzi has also demonstrated high response rates and durable remissions in patients with relapsed or refractory NHL.

CAR T cell therapy works by genetically modifying a patient’s T cells to recognize and attack cancer cells. In the case of lymphoma, the CAR T cells are engineered to target a protein called CD19, which is present on the surface of B cells, the type of cell that is often affected in lymphoma.

Car T Cell Therapy for Multiple Myeloma

CAR T cell therapy is a promising new treatment for multiple myeloma, a type of cancer that affects plasma cells in the bone marrow. Several therapies are currently in development for the treatment of multiple myeloma, and some have already shown promising results in clinical trials.

One of the most advanced cell therapies for multiple myeloma is bb2121, which is being developed by Bluebird Bio and Bristol Myers Squibb. In clinical trials, bb2121 has demonstrated high response rates and durable remissions in patients with relapsed or refractory multiple myeloma. Another CAR T cell therapy for multiple myeloma that is currently in development is JNJ-68284528, which is being developed by Janssen Biotech.

This therapy for multiple myeloma works by genetically modifying a patient’s T cells to recognize and attack cancer cells. In the case of multiple myeloma, the CAR T cells are engineered to target a protein called BCMA, which is present on the surface of myeloma cells.

Car T Cell Therapy Side Effects

While therapy has shown promising results in treating certain types of cancer, it can also cause side effects that range from mild to severe.

Some common side effects of CAR T cell therapy include:

  1. Cytokine release syndrome (CRS): This is a systemic inflammatory response that can occur when the CAR T cells are activated and begin attacking cancer cells. Symptoms of CRS can include fever, chills, fatigue, nausea, vomiting, low blood pressure, and difficulty breathing.
  2. Neurotoxicity: Therapy can also cause neurological side effects, such as confusion, seizures, and hallucinations.
  3. Low blood cell counts: Therapy can cause a drop in white blood cells, red blood cells, and platelets, which can increase the risk of infections, anemia, and bleeding.
  4. Infections: Because therapy can lower the number of white blood cells, patients may be at increased risk of developing infections.
  5. Infusion reactions: Some patients may experience allergic reactions or other side effects during the infusion of CAR T cells.
  6. Tumor lysis syndrome: Therapy can cause cancer cells to break down quickly, which can release toxins into the bloodstream and cause electrolyte imbalances.

The severity of these side effects can vary from person to person, and some patients may experience no side effects at all. It is important for patients to be closely monitored during and after cell therapy to manage these potential side effects. In some cases, medications such as corticosteroids or other supportive therapies may be used to manage side effects.

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