Overview

CAR T-cell therapy uses a patient’s own immune system to fight cancer. Anti-CD19 CAR T-cell therapy for lymphoma involves collecting a patient’s T-cells (immune cells) from their blood and genetically engineering them to express a specific receptor against the CD19 protein present on their lymphoma cells. These cells are then re-infused back into the patient to find and attack the lymphoma cells.

What is CAR T-cell Therapy?

CAR T-cell therapy is a type of cellular immunotherapy which targets a patient’s own immune cells to use directly against their cancer cells. Unlike traditional drugs, CAR T-cells are a “living drug”, where a single infusion can produce deep and durable remissions.

A patient’s blood is collected through a process called apheresis. T-cells are separated from the collected blood. T-cells, or T lymphocytes, are immune cells which normally fight infections in the body and provide surveillance against cancer. After the T-cells are separated, they are then engineered and multiplied to locate and attack cancer cells. The engineered t-cells are then infused back into the same patient.

In the case of B-cell lymphoma, the most widely used target is CD19. The new anti-CD19 receptor, known as a chimeric antigen receptor, or CAR, then appears on the surface of the patient’s own T-cell, making it a targeted killer of B-cell lymphoma cells. When re-infused, these cells seek out and specifically target lymphoma cells for destruction.

Yescarta

Yescarta is FDA approved for adult patients with relapsed or refractory large B-cell lymphoma (DLBCL), primary mediastinal large B-cell lymphoma (PMBCL), high-grade B-cell lymphoma, and DLBCL arising from follicular lymphoma (transformed follicular lymphoma). Patients must have received two or more other forms of cancer treatment which did not successfully treat their cancer.

Yescarta was FDA approved based on a multicenter clinical trial in 101 patients with chemotherapy-refractory large B-cell lymphoma. The clinical trial produced an overall response rate of 82% and complete response rate of 54%. At 6 months, 41% of treated patients remained in ongoing remission.

The process for treatment with Yescarta:

  • Patient undergoes apheresis for T-cell collection
  • T-cells are engineered
  • Cells are then expanded in the laboratory and tested for safety
  • Patient receives 3 days of low dose chemotherapy to prevent the cells from being rejected when re-infused
  • Patient is admitted to the hospital where the CAR T-cells are re-infused
  • Patient is then monitored for potential side effects

Yescarta is FDA-approved and available for patients who have relapsed diffuse large B-cell lymphoma (DLBCL), primary mediastinal B-cell lymphoma (PMBCL), high grade B-cell lymphoma (HGBCL) including double hit lymphoma (DHL), or transformed follicular lymphoma (tFL). Eligible patients must have received at least 2 prior lines of systemic therapy.

To arrange a consultation, please call us at 617-724-6862 or email us at MGHCellularTherapy@partners.org.

Qualifications

Yescarta

To be a candidate for Yescarta, patient must:

  • Have large B-cell lymphoma subtypes including diffuse large B-cell lymphoma, high grade B-cell lymphoma, primary mediastinal B-cell lymphoma, and transformed follicular lymphoma
  • Be 18 years or older
  • Have received two or more other forms of cancer treatment which did not successfully treat their cancer

To arrange a consultation, please call us at 617-724-6862 or email us at MGHCellularTherapy@partners.org.

Additional Options

We also have JCAR017 available on clinical trials for relapsed lymphoma. View the clinical trial details here.

Learn more about the Mass General Cancer Center's Lymphoma treatment program.

Meet the Team

The Mass General Cancer Center is an authorized treatment center for Yescarta. To help bring this new therapy to patients, our experienced specialists work as a team to coordinate all aspects of patient care.

Jon and JoAnn Hagler Center for Lymphoma

Every patient in the Jon and JoAnn Hagler Center for Lymphoma has a multidisciplinary care team of specialists who coordinate and oversee his or her care. In addition, each team includes nurses who specialize in the treatment of lymphoma, as well as social workers, nutritionists and other professionals. Meet the rest of the team here.

Cellular Immunotherapy Program

At the Mass General Cancer Center, we are committed to make CAR-T cells work for many cancers. Learn more about the Cellular Immunotherapy Program at the Mass General Center and meet the team here.

Videos

Learn more about CAR T-Cell Therapy in this series of videos. Kiss 108 FM’s Billy Costa talks with four experts from the Mass General Cancer Center to learn about what CAR T-Cell Therapy is and what impact it has on both patients and the medical community.

FAQs

Here you will find information that you need to know about treatment with CAR T-Cell Immunotherapy for Lymphoma. For more details, please refer to our brochure.

What are T-cells?

T-cells are lymphocytes, which are a type of white blood cells. White blood cells fight infection.

What is immunotherapy?

Immunotherapy is a type of cancer treatment that uses the body’s immune system to find and attack cancer cells. CAR T-cell therapy is a type of immunotherapy.

What is CAR T-cell therapy? How does it work?

CAR T-cell therapy uses your own immune system to help fight cancer cells. Your blood is collected through a process called apheresis, sometimes called leukapheresis. This process separates your T-cells from the rest of your blood. The T-cells are then sent to a lab where they are engineered specifically to attack B-cell lymphoma cells. The engineered T-cells are then multiplied and shipped back to the hospital. Back in the hospital, the cells are given back to you through an IV infusion

CAR T-cell therapy is a complex treatment. It can cause severe side effects. Because of this, it is only given during a stay in the hospital. You will be carefully monitored by your treatment team for any side effects. You will also be told about side effects and how to best care for yourself after you leave the hospital.

What is apheresis?

T-cells are collected from your blood by apheresis, a process that takes blood from the body and removes one or more blood components such as plasma, platelets, or white blood cells. The remaining blood is then returned to the body.

What is an infusion reaction?

An allergic response when the CAR T-cells are being infused into your blood. Your treatment team will monitor your vital signs and labs closely during your CAR T-cell infusion. You will also be given Tylenol and Benadryl before the CAR T-cell infusion to help stop a reaction.

How long will I need to stay in the hospital?

Your hospital stay may range from one week to one month, or potentially longer. The length of stay depends on your body’s reaction to the CAR T-cell infusion and possible side effects.

What side effects should I be aware of?

You will be very carefully monitored after your infusion for any side effects. Report any of these side effects to your treatment team right away!

Possible side effects include:

  • Cytokine release syndrome (CRS), which can include fevers, low blood pressure, low oxygen levels, fast heartbeat, confusion, and temporary kidney and liver abnormalities
  • Neurologic toxicities, which can include confusion, excessive sleepiness, tremor, or seizures
  • Decreased blood counts
  • Increased risk of infection
  • Fever
  • Chills
  • Swelling in hands, arms, feet, and legs
  • Increased risk of bleeding

If you experience any of these side effects after you leave the hospital, call your treatment team right away:

  • Fever
  • Confusion
  • Excessive sleepiness
  • Seizures
  • Symptoms of infection
  • Bleeding

Family members are often the first to notice changes in behavior such as trouble remembering or confusion. Family members should report these changes to your treatment team.

What can I expect before my CAR T-cell infusion?
  • You will have a medical and laboratory evaluation with a lymphoma specialist to determine if CAR T-cell therapy is right for you.
  • Your lymphoma will be re-staged with a PET-CT scan, if one has not been recently performed.
  • You will meet with a social worker to evaluate your psychosocial needs and determine the support we can provide you and your family.
  • You will undergo apheresis, a process where your blood is collected and processed to obtain the T-cells.
  • Before being admitted to the hospital, you will receive chemotherapy that is designed to prepare your body for the CAR T-cell infusion.
  • Your nurse will talk with you about your supportive care team members. You will meet with an Oncology Social Worker. You have access to a Nutritionist, Spiritual Care Provider, or a member of the Parenting At a Challenging time (PACT) team at any time before, during, and after your infusion.
How should I prepare? What do I need to know now to prepare for my care after my infusion?
  • You should have someone living with you in your house for at least one month after your infusion.
  • You should avoid driving or operating heavy machinery for up to 2 months after your infusion.
  • You must live within 2 hours drive of the hospital for a month after your infusion.
  • You will need to set up a healthcare proxy, if you do not already have one. Your treatment team can provide you with a healthcare proxy form.
  • You will receive a patient wallet card and should carry it with you at all times. If you see a doctor, you should give this card to them.
What should I do to care for myself after I leave the hospital?

Your treatment team will talk with you about how to care for yourself when you leave the hospital. They will give you specific information about personal care, mouth care, and hand washing. They can answer any other questions that you may have.

For more information about treatment with CAR T-Cell Immunotherapy for Lymphoma, please refer to our brochure.

 

 

 

 

 

 

 

Resources

Patient Education Materials

www.yescarta.com

News & Publications

Yescarta press release

Contact Us

For more information about this lymphoma CAR T-cell therapy and to arrange a consultation, please call us at 617-724-6862 or email us at MGHCellularTherapy@partners.org.

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