CAR T cell therapy

What if we could re-program a patient's immune system to recognize their own cancer and attack it? That is the goal of immunotherapy. Chimeric antigen receptor T cells, or CAR T cell therapy, is the first FDA-approved treatment of this kind.

• Vanderbilt is the only approved center in the state of Tennessee able to offer the FDA-approved CAR T cell treatment for pediatric acute lymphoblastic leukemia (ALL).
• Vanderbilt is also participating in a clinical trial with CAR T cell therapy for patients with relapsed and refractory ALL.
• The patient’s immune cells will be collected and reprogrammed to recognize her cancer cells and kill them throughout her body.

Tisagenlecleucel, also known by the brand name Kymriah, is FDA approved for children and young adults up to the age of 25 with B-cell ALL that is refractory or in second or greater relapse.

Vanderbilt is also able to offer another CAR T cell therapy called axicabtagene ciloleucel (axi-cel) through a clinical trial. Patients must be ages 2 to 25 with B cell ALL that is refractory to initial treatment or relapsed and refractory to at least two lines of therapy, or relapsed after allogeneic stem cell transplant.

Once a patient qualifies for treatment, there are many steps involved in the process.

• First, the patient will need to have their immune cells collected.
• The collected immune cells are sent to specialized manufacturing centers to be reprogrammed to recognize the patient’s cancer cells.
• The cells then are returned to Vanderbilt.
• Most patients will receive several days of chemotherapy to help prepare the body for the CAR T cell infusion. The chemotherapy can be given either inpatient or outpatient depending on how well the patient is doing.
• The CAR T cell infusion will happen in our inpatient myelosuppression unit. The infusion is done through a catheter (IV infusion), and typically takes less than 30 minutes.  
• The patient will remain inpatient for observation for at least seven days after infusion. This is the period of time when side effects are most likely to occur. Side effects such as high fevers and low blood pressure are common, but usually reversible.
• When all the side effects have resolved, the patient is able to be discharged from the inpatient unit but will need to stay in the Nashville area for at least 28 days following the infusion.

If you would like more information about this therapy, please call (615) 936-6989.