| CAR-T cell therapy is a new treatment option for certain blood cancers. Here the Bastion Brands Medical Education team explains what it is all about in a fascinating three-minute read.
CAR-T Central is a platform developed by Bastion Med Ed, dedicated to the education of the haematology community on CAR-T cell therapy. It illustrates the power of collaborative, independent medical education to provide credibility for the clinical data associated with your brand and increase brand awareness with key opinion leaders and other health care professionals.
What is CAR-T?
CAR-T cell therapy is a recently developed treatment option for patients with certain types of blood cancers.1 It is a type of immunotherapy which involves the genetic engineering of the patient’s own immune cells, allowing them to specifically target and destroy cancer cells.
To create CAR-T cells, a patient’s own T-cells are collected and cultured in the laboratory. Next, chimeric antigen receptors (CARs) are integrated into the host cell’s genome using genetic engineering techniques. The resulting CAR-T cells recognise a specific surface antigen on cancer cells. These specialised CAR-T cells are then expanded in culture media, isolated, and formulated in infusible media before being transferred back into the patient.
Approved CAR-T therapies in Australia
There are currently three approved CAR-T therapies in Australia. Kymriah® (tisagenlecleucel) is approved for relapsed or refractory B-cell precursor acute lymphoblastic leukaemia (ALL), as well as relapsed or refractory diffuse large B-cell lymphoma (DLBCL) after prior systemic therapy.2 Yescarta® (axicabtagene ciloleucel) is approved for relapsed or refractory large B-cell lymphoma after prior systemic therapy.3Tecartus® (brexucabtagene autoleucel) is approved for relapsed or refractory mantle cell lymphoma after prior systemic therapy, including a BTK inhibitor.4
The Australian Government funds Kymriah for the treatment of children and young adults with ALL and adults with DLBCL. Yescarta is also publicly funded for the treatment of DLBCL. At this stage, CAR-T cell therapy is not reimbursed for other indications.5. Recently the Peter McCallum Cancer Centre became the first centre in Australia to be approved for the manufacture of CAR-T cell therapy.6
The CAR-T treatment process7
There are several steps in the CAR-T treatment procedure. First, the patient’s T-cells are collected via a process called leukapheresis and then the CAR-T cells are manufactured as described above. Some patients may require bridging chemotherapy to control disease progression whilst the CAR-T cells are being manufactured.7
Patients generally undergo lymphodepleting conditioning before receiving the infusion of CAR-T cells, to create a favourable environment for CAR-T cell expansion and survival. The specialised CAR-T cells are then transferred back into the patient, so that they can directly target and destroy cancer cells.7 The CAR-T cells continue to grow and multiply within the patient, eliciting ongoing anti-tumour effects. CAR-T cell persistence varies with several production and clinical factors.1
Future steps in CAR-T cell therapy
CAR-T immunotherapy is a rapidly evolving area of research and development. With the success of CAR-T in blood cancers, including ongoing studies in multiple myeloma, research to expand this innovative treatment option to solid cancers is progressing rapidly.8 However, adapting CAR-T therapy for solid tumours is not without challenges. The high variation in the type and volume of antigens expressed by solid tumour cells could impair the ability of CAR-T cells to recognise cancerous cells.8 CAR-T cells travel throughout the body in the bloodstream and lymphatic system, which is why they are effective in targeting and attacking blood cancers.8 However, solid tumours are made up of dense fibrous tissue, and express various factors which may act to limit the migration of CAR-T cells and their capability to penetrate the tumour. Unlike the pathological process in haematological cancers, immune cells often populate the solid tumour microenvironment, which can support tumour growth and metastasis, and hence may influence the efficacy of CAR-T treatment.8
These recent developments in the CAR-T therapy space are just the beginning of personalised immunotherapy for cancer patients in Australia. To learn more about CAR-T therapy in Australia, please visit www.car-tcentral.com.au
Donna Bartlett
Medical Education Manager |
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Olivia Holland
Medical Writer |
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