As part of our
comprehensive treatment for hematologic malignancies, UC San Diego Health is offering CAR T-cell therapy, a promising type of
immunotherapy, for certain types of
UC San Diego Health has been a pioneer in advancing personalized cancer therapies and is one of a select number of medical centers nationwide that helped establish the effectiveness of CAR T-cell therapy.
With our depth of expertise and familiarity with this relatively new cellular therapy, we are able to offer our patients CAR T-cell therapy with:
- Yescarta (axicabtagene ciloleucel) for adults with relapsed or refractory B-cell lymphoma
- Kymriah (tisagenlecleucel) for children and young adults with relapsed or refractory B-cell precursor acute lymphocytic leukemia
Our physicians are also involved in several
clinical trials of CAR T-cell therapies.
What Is CAR T-Cell Therapy?
It is an
type of immunotherapy based on genetically modifying a patient's T-cells to fight cancer. CAR stands for chimeric antigen receptor. These receptors are proteins on the T-cells' surface engineered to recognize a specific antigen (protein) found on certain cancer cells. These receptors can be thought of as claws that enable T-cells (white blood cells) to find and grasp tumor cells. In a laboratory, a deactivated virus is used to insert genes into the T-cells that direct the production of these receptors. These CAR T-cells are then grown in the lab until there is a sufficient quantity of cells for therapy. Because a person's own T-cells are used in treatment, CAR T-cell therapy is a type of personalized cancer therapy, also sometimes referred to as a living drug.
Although immunotherapies are incredibly promising, not all patients respond fully to CAR T-cell therapy. In some patients, therapy may be used as a bridge to a blood or marrow transplant (BMT). UC San Diego Health has the
largest BMT program in the region and a new patient-centered transplant unit within
Jacobs Medical Center that provides patients and family with the highest level of comfort and care.
What Does Treatment Involve?
- Prior to treatment, you will have a consult with a CAR T-cell physician who will review your medical history and discuss other aspects of your care and suitability for this immunotherapy. To be eligible for CAR T-cell therapy, you must have already received two unique regimens of chemotherapy or other systemic treatment.
- The first step of treatment involves the collection of lymphocytes from your blood. This is done using a process called leukapheresis, in which your blood is circulated on a medical device and the lymphocytes are separated from the other components of your blood. The other components (such as plasma and red blood cells) are returned to you via an intravenous catheter. The lymphocytes are sent to a special laboratory for re-engineering, proliferated at the lab and then sent back to our hospital. This process may take a few weeks.
- In advance of your CAR T-cell therapy, you will undergo three days of mild chemotherapy. You then receive a single infusion of CAR T-cells and are carefully observed following the infusion for side effects of treatment.
- Potential adverse effects of treatment include fever, low blood pressure, difficulty breathing and mental changes. These symptoms can be managed and are completely reversible.
- Patients typically spend a couple weeks in the hospital so that they can be continuously monitored. Our care teams are trained to recognize and treat the potentially serious side effects of treatment.
- Once your health has stabilized, you will be discharged from the hospital with a plan for ongoing care. This plan will include blood tests and scans to carefully follow your progress. You will also be invited to take advantage of our comprehensive care services which include
Why Choose UC San Diego Health?
Our BMT team treats more patients every year than any medical center in the region.
Expertise: We have expertise in new and novel cancer treatments because our physicians often conduct the studies that lead to their development.