Chimeric antigen receptor (CAR) T-cell therapy is a novel form of immunotherapy that uses a patient’s own immune system to fight myeloma.
Immune cells called T cells are extracted from the patient’s blood through an IV line and go into a machine that takes out the T cells. After that, the remaining blood goes back into the body.
The removed T-cells are modified in a laboratory to produce chimeric antigen receptors, surface-level proteins that enable the T cells to recognize and fight targeted antigenic tumor cells. The addition of CAR to the T cells help the cells attach to proteins on the cancer cells.
After the T cells are newly engineered in the lab over several weeks, they are infused back into the patient’s body, where they further multiply and go to work attacking cells that possess the antigen that they were programmed to destroy.
Often patients receive chemotherapy prior to CAR T-cell therapy in order to prepare the body for the infusion.
Also in development are “off-the-shelf” CAR T-cell therapies, which are created using donor cells that are universally engineered to recognize and fight antigenic myeloma cells. These engineered cells could treat a large portion of patients from a single batch of CAR T-cells instead of individualized T cell extraction from each person.
Patients will be monitored after CAR T-cell therapy to watch for any side effects. A few possible side effects of CAR T-cell therapy exist including:
Cytokine release syndrome (CRS): Sometimes T cells release chemicals called cytokines that ramp up the immune system. Noticing high fever, chills, trouble breathing, severe nausea, dizziness, headaches, a fast heartbeat, or extreme fatigue after receiving CAR T-cell therapy, may indicate CRS and should be shared with the care team.
Nervous system problems: Occasionally treatment may impact the nervous system causing headaches, confusion, seizures, twitching, loss of balance, or changes in consciousness.
Other side effects: Additional side effects have been known to occur, including allergic reactions during the infusion, a weakened immune system, or low blood cell counts.