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The U.S. Food and Drug Administration (FDA) has approved the CAR T-cell therapy, Yescarta (axicabtagene ciloleucel), for the treatment of adult patients with relapsed or refractory large B-cell lymphoma. This therapy is available at the Mass General Cancer Center.
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.
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 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:
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.
To be a candidate for Yescarta, patient must:
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.
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.
Clinical Director, 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.
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.
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.
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.
T-cells are lymphocytes, which are a type of white blood cells. White blood cells fight infection.
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.
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.
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.
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.
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.
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:
If you experience any of these side effects after you leave the hospital, call your treatment team right away:
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.
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.
Yescarta press release
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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