Tulane Medical Center was recently accredited by the Foundation for the Accreditation of Cellular Therapy (FACT) to provide chimeric antigen receptor (CAR)-T cell therapy to patients with certain hematologic malignancies, making Tulane the only FACT-accredited center for this type of cancer treatment in Louisiana.
"We are very excited to offer this new therapy to eligible patients with acute lymphoblastic leukemia, diffuse large B-cell lymphoma, multiple myeloma, follicular lymphoma, and mantle cell lymphoma," said Hana Safah, MD, director of Tulane's Stem Cell Transplant Program. "We are currently evaluating patients and expect to begin treating within the next three months."
CAR-T cell therapy is a form of immunotherapy that re-engineers a patient's T cells – immune system cells that help to orchestrate immune response – to express proteins called chimeric antigen receptors (CARs) on their surface that will recognize cancer cells, bind to antigens on the surface of these cancer cells and then destroy them.
The T cells are harvested from patients via a blood collection and are then re-engineered in the lab through the insertion of the gene for CAR. Millions of these new CAR-T cells are grown in the lab and then infused back into the patient, where they multiply in the patient's body and with guidance from their engineered receptor, recognize and kill cancer cells that harbor the target antigen on their surfaces.
Since 2017, six CAR-T cell therapies approved by the Food and Drug Administration have shown an ability to eradicate very advanced leukemias and lymphomas and to keep them at bay for many years in some patients.
"The treatment process is lengthy," said Nakhle Saba, MD, associate professor of clinical medicine in the Stem Cell Transplant Program. "It takes a few weeks to collect the patient's blood, isolate the T cells, ship the cells to our commercial partner where they will be re-engineered and multiplied, and then ship them back for infusion."
But researchers are working on ways to improve the process. "Including clinical trials in the pipeline at Tulane and elsewhere that are harvesting T cells from healthy donors and re-engineering them so they're 'on the shelf' and ready to use when sick patients need them," said Saba, "as well as trials that are examining the role of CAR cell therapies using other types of immune cells, such as NK or natural killer cells, in an effort to overcome some of the side effects of CAR-T."
These side effects can include a reduction in antibody-producing B cells, infections, neurologic issues, and a condition called cytokine release syndrome, which can cause high fevers and drops in blood pressure. In many patients, side effects can be managed with drugs or steroids.
If you are interested in learning more about CAR-T cell therapy or the clinical trials mentioned above, please contact Tulane Cancer Center's Stem Cell Transplant Program at 504-988-6070 or email Dr. Safah at firstname.lastname@example.org or Dr. Saba at email@example.com.