CAR T-Cell (CART) Therapy

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CAR T-Cell Therapy (CART)

Chimeric Antigen Receptor T-cell therapy (also known as CAR-T therapy) is a type of cancer treatment where the patient’s own immune T-cells are genetically modified in the laboratory to fight cancer cells. In CAR-T therapy, T-cells are taken from the patient’s blood and then modified in the laboratory by adding a gene for a receptor (known as Chimeric Antigen Receptor or CAR).  These receptors help these modified T-cells to identify and to attach themselves to the cancer cells so that they can attack these cancer cells throughout the body. CAR-T therapy is able to treat certain conditions such as myeloma, some leukaemias and some lymphomas.

Click to view Leukaemia and Lymphoma society video on CAR T-cell therapy 
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Different cancer types have different antigens and as such, each CAR-T therapy have to be custom-made for the patient’s cancer specific cell type.  Here is a list of CAR-T therapy (note that the list way differ in different countries);

  • Tisagenlecleucel also known as Tisa-Cel (Kymriah)
  • Axicabtagene ciloleucel also known as Axi-Cel (Yescarta)
  • Brexucabtagene autoleucel also known as Brexu-Cel (Tecartus)
  • Lisocabtagene maraleucel also known as Liso-Cel (Breyanzi)
  • Idecabtagene vicleucel also known as Ide-Cel (Abecma)
  • Ciltacabtagene autoleucel also known as Cilta-Cel (Carvykti)
Image CAR T Therapy Process

What is the process for CAR T-cell therapy?

    Step 1 : Collection of Patient’s T-Cells

    The patient’s T-cells are first collected from the patient’s blood using a process called Leukapheresis.  This procedure may take between 2-4 hours with the patient sitting comfortably on a chair or lying in bed

    Step 2 : Manufacturing the CAR T-cells

    These T cells are then sent to a laboratory where they are genetically modified for the specific Chimeric Antigen Receptor (CAR).  These cells known as CAR T-cells are then grown and multiplied in the laboratory to a sufficient amount for the patient’s therapy

    Step 3 : Treatment using the CAR T-cells infusion

    After the manufacturing process, the CAR T-cells will be delivered back to the hospital to treat the patients.  The patient may require a Bridging Therapy prior to the CAR T-cell therapy.  This treatment depends on several factors such as patient’s age, patient’s health, the type of cancer, disease burden as well as your Cancer Specialist decision.

    Click to view MMRF video on CAR T-cell therapies

    Potential Side-Effects of CAR T-cell therapy

    Short term side effects include fatigue, infection, cytokine release syndrome (see below) and neurotoxicity while long term side effects include hypogamma-globulinaemia and secondary cancers.  Cytokine release syndrome (CRS) occurs when large amounts of chemicals called cytokines are released by the CAR T-cells into the blood when fighting the cancer cells. These CRS symptoms include;

    • Feeling tired or fatigue 
    • High fever or riggers
    • Difficulty breathing
    • Nausea, vomiting or diarrhoea
    • Dizziness or lightheadedness
    • Headaches
    • Muscle and joint aches
    • Fast heart rate or low blood pressure

    More serious side effects include;

    • Allergic reaction during the treatment
    • Increased risk of getting infection due to low white blood cell counts
    • Increased risk of bruising or bleeding due to low platelet counts

    Do inform your Cancer Specialist Team any side effects you may be having and update them at every clinic visit regarding your health status


    Disclaimer. TELEME blog posts contains general information about health conditions and treatments. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. The information is not advice and should not be treated as such. 

    If you think you may be suffering from any medical condition, you should seek immediate medical attention from your doctor or other professional healthcare providers. You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of information on this website.

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