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Swedish Cancer Institute is proud to offer Chimeric Antigen Receptor (CAR)-T cell therapy to qualifying patients, one of the newest forms of immunotherapy that has produced widespread patient remission since its approval in 2017. Immunotherapy is a form of cancer treatment that helps your immune system fight cancer. Since most cancers are smart enough to hide and have the ability to remain undetected by our bodies’ immune system, often radiation and chemotherapy are the only treatment options. However, recent advances have allowed scientists to modify the cells of our immune system to recognize and destroy cancerous cells.
CAR-T cell treatment is a type of immunotherapy in which a patient’s T-cells are modified and the CARs are manufactured in a laboratory, utilizing immune cells to bind to cancerous cells and destroy them. T-cells are a type of white blood cells, which are hugely important to the way our immune system responds to intruders.
The treatment begins with the removal of the patient’s T-cells using a centrifuge. Once the T-cells are removed, they are sent to a laboratory where they are genetically engineered, by modifying their DNA, and attaching them to receptor proteins. This process creates Chimeric Antigen Receptors (CAR). These modified cells have the ability to multiply which in turn helps to identify and destroy cancer cells.
Prior to the reinfusion of the CAR-T cells, the patient will undergo low dose chemotherapy to deplete cells and provide space for the new CAR-T cells. Currently, one CAR-T product requires the patients to stay both inpatient and outpatient so that they can be monitored closely for the first 30 days.
The standout advantage of CAR-T cell treatment is that the patient will have less active treatment days than undergoing traditional therapy. The treatment potentially can help get a patient into complete remission for many years. Its effectiveness and the short recovery period makes this an attractive option. In addition, the treatment is considered a “living drug”, meaning that the infused T-cells can persist in the patient’s body long term, and can continue to fight the treated cancer. Finally, the idea behind this treatment is exciting; nearly 50% of patients treated with the current CAR-T cell therapy find success.
The side effects of CAR-T cell therapy can be serious in some cases. The most prominent side effect is the activation of an inflammatory condition referred to as cytokine release syndrome (CRS). Symptoms are similar to those of the flu; high fever, chills, and low blood pressure, but as CRS can potentially be life-threatening, it is also highly manageable. During treatment, patients are closely monitored for temporary neurological effects, such as confusion and slurred speech as well. It is also possible that a patient will experience low levels of red blood cells, and white blood cells in response to the therapy. It is encouraged to refer to your doctor for any questions regarding side effects.
As this form of treatment was only recently approved for application in April of 2017, insurance providers are still working on preparing policies for FDA approved therapies such as CAR-T cell therapy. Currently, coverage will be determined on a case to case basis, but we will work with the patient and associated insurers to seek coverage for eligible patients.
To learn more about the CAR-T cell treatment, please call or consult with your medical oncologist at Swedish Cancer Institute, or call 1-(855)-XCANCER (1-855-922-6237).
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• CAR T-Cells: Engineering Immune Cells to Treat Cancer. (n.d.). Retrieved from https://www.cancer.gov/about-cancer/treatment/research/car-t-cells
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