Page 36 - Delaware Medical Journal - May/June 2020
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Chimeric Antigen Receptor T-Cell Therapy
Jamal Misleh, MD; Peter Abdelmessieh, DO
Chimeric antigen receptor T-cell therapy (CAR T) is a novel way to harness the body’s immune system
to attack and eliminate cancer, making it a form of cellular therapy. Along with other emerging therapies in immunotherapy, cancer. Treatments for cancer are now moving away from traditional cytotoxic chemotherapy into personalized, molecularly targeted therapies.
CAR T is one of these new therapies that has already changed how cancer is treated and can cure patients who have few options after traditional therapy
has failed. This therapy is considered a have been demonstrated in lymphoma studies for years.
CAR T is now approved to treat B-cell
acute lymphoblastic leukemia1 (ALL; up to age 25) and aggressive B-cell lymphomas that have failed traditional therapy, notably two lines of treatment, which can include an autologous stem cell transplant. The technology is rapidly evolving and it is expected there will be numerous new indications in
the near future, such as for multiple myeloma, chronic lymphocytic lymphoma, and mantle cell lymphoma.
CAR T base-cell therapy is only available at select cancer centers
with specialized expertise in cellular therapies that are recognized for quality by the Foundation for the Accreditation of Cellular Therapy (FACT). The ChristianaCare Helen F. Graham Cancer Center & Research Institute (HFGCCRI) Bone Marrow and Stem Cell Transplant Program is the only
adult patients with advanced B-cell lymphomas with CAR T. There are currently two products commercially available: Tisagenlecleucel (Kymriah; B-cell ALL and aggressive B-cell lymphoma) and Axicabtagene (Yescarta; aggressive B-cell lymphoma).
The CAR T-cell process starts by collecting a patient’s CD 8+ T cells. These cells are then genetically
two important aspects regarding T-cell targeting and function: it allows patient- collected T cells to recognize and
target the cancer cells. For the current approved agents, the target is CD19, which is universally expressed on B-cell involves engineering an activating
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Del Med J | May/June 2020 | Vol. 92 | No. 3
