Page 37 - Delaware Medical Journal - May/June 2020
P. 37
TREATMENT
Source: htts://labiotech.eu/immune-oncology-histroy-car-t-nyt/. Accessed March 7 2019/ Levine BL. Cancer Gene Ther. 2015; 22-79-84
domain of the T cell, which enhances its activity and effectiveness once it is re- infused into patients. The cells are then grown to increased number, which in total takes about three to four weeks.
The patient receives “lympho-depleting therapy” within 14 days prior to re- back into the patient, in order to aid proper T-cell expansion within the patient. The lympho-depleting therapy is usually outpatient and not very intensive.
The recovery period for CAR T is generally two to three months. After the infusion, patients may spend up to three weeks in the hospital to monitor treatment response and any side effects, but if no side effects are seen, patients can be discharged within a week.
the hospital, patients are required to remain close to the treatment center
for regular follow-up care, due to the unique toxicities associated with this therapy. CAR T does not normally create the side effects associated with chemotherapy, like nausea, vomiting, and hair loss.2 It can, however, create
release syndrome) and ICANS (immune effector cell-associated neurotoxicity syndrome). The toxicities have now been well described and management strategies have evolved to help lower the toxicity of these therapies. Treatment
is starting to move to the outpatient setting in certain circumstances, and at the HFGCCRI, the expectation in the future is to primarily treat patients in the outpatient setting.
Limitations to this therapy include ineffective T cells due to previous therapies, lack of target, loss of target (multiple targets; adjust target), and time needed to produce cells.
We currently provide CAR T at the HFGCCRI’s Bone Marrow and Stem Cell Transplant Program. We have already successfully treated patients. B-cell lymphoma is in remission six months later. This patient’s cancer
had progressed rapidly despite a third round of chemotherapy, so the CAR T Cell Multidisciplinary needed to move quickly. The HFGCCRI’s Bone Marrow and Stem Cell Transplant Program
is actively working to expand our capabilities to these emerging therapies.3 This program allows patients to stay in Delaware for their cancer treatment.
Del Med J | May/June 2020 | Vol. 92 |
No. 3
133
