CAR T-Cell Therapy Continues to Give Patients Hope
- Emily Whitehead, 18, was the first pediatric cancer patient to receive CAR T-cell therapy. She’s now 11 years cancer-free and attends the Univ. of Pennsylvania as a student, which happens to be where she received the groundbreaking treatment.
- Whitehead was diagnosed with acute lymphoblastic leukemia, a type of blood cancer, at five years old.
- CAR T-cell therapy is sometimes called a “living drug” because it uses your own immune cells, which are reprogrammed to attack a unique aspect of your cancer. Essentially, these re-engineered cells take over the cancer-fighting work of your immune cells. 80% of patients have a response to CAR T-cell therapy after other treatments have failed.
- CAR T-cell therapies are generally well tolerated, with some patients experiencing no side effects. However, neurotoxicity is a side effect that can emerge. Symptoms of neurotoxicity can range from mild to severe. With a mild case, you may feel a little fuzzy or confused.
- “These therapies are costly, in the order of $400,000 to $500,000 just for the product, just for the T-cells,” Dr. Thomas Martin, a hematologist at the University of California San Francisco Medical Center, tells SurvivorNet.
- Though Medicare and some private health insurance companies do cover the cost of CAR T-cell therapy for people who qualify, they may not pay for everything. If this treatment is an option for you, speak with a patient navigator at your medical facility to learn more about its costs.
Emily Whitehead, 18, is a freshman at the University of Pennsylvania in Philadelphia. However, unlike many of her peers on campus, she’s returning to the institution with a chip on her shoulder. She was the first child to be cured of leukemia at the school roughly a decade earlier, thanks to the groundbreaking CAR-T cell therapy. This form of treatment essentially retrains your immune system to make it more efficient at fighting cancer.
She first came to the university for treatment when she was six years old in 2012 for treatment. Since then, she has lived the life of a medical celebrity by becoming the face of what CAR-T cell therapy can do for patients looking for a hopeful outcome. She’s now 11 years “Cancer-free” and looks forward to the next chapter in her life while still advocating for cancer patients.
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CAR-T therapy involves removing T-cells from the body and training them to recognize cancer cells in a laboratory. This is done by genetically modifying the cells and growing them in large numbers. When infused back into the body, these new cells seek out and destroy the Chronic lymphocytic leukemia cells.
Although Whitehead was the first pediatric patient to receive the treatment more than a decade ago, the Philadelphia Inquirer reports that “at least 20,000 people have received CAR-T treatment, with success rates ranging from 50% to 90%.”
RELATED: The Promise of CAR T-Cell Therapy for Multiple Myeloma
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Whitehead has often shared her story and celebrated her remission across various media outlets and organizations, including the foundation that bears her namesake – the Emily Whitehead Foundation – that supports pediatric cancer research.
“We’re just so pleased to be partnered with the Emily Whitehead Foundation and to find ways to fund and ultimately support the families before, during, and after the treatment process,” Audrey Greenberg, Co-Founder and Chief Business Officer, Center for Breakthrough Medicines, said in a statement to BioBuzz.
“Cancer survivors have more to them than their stories,” Whitehead said. She intends to wind down drawing attention to her own success story and continue focusing on supporting other cancer patients and their families while focusing on her college studies.
“I am so grateful for everything I have gotten to experience these last eleven years. while this will be the last official cancer-free pic, it certainly won’t be the end of me making the most of my life without cancer,” Whitehead said in an Instagram caption.
Helping You Better Understand CAR T-Cell Therapy
- CAR T-Cell Therapy Side Effects Can Be Serious, But Many Are Short-Lived
- CAR T-Cell Therapy and BiTE: Two New Approaches to Multiple Myeloma Treatment
- CAR T-Cell Therapy for Non-Hodgkin Lymphoma
- CAR T-Cell Therapy’s Current and Future Success
- CAR T-Cell Therapy: What You Should Know About Side Effects
- CAR T-Cell Therapy: How it Works, and Who Can Get It
Understanding CAR-T Cell Therapy
Your immune system comes equipped with an army of white blood cells, called T cells, that normally protect it from infections and cancer. But sometimes, these cells miss their target. “The cells that help fight cancer unfortunately don’t recognize their own cancer anymore,” Dr. Julie Vose, chief of hematology/oncology at the University of Nebraska Medical Center, tells SurvivorNet. CAR T-cell therapy “helps to wake up those cells to be able to fight cancer.”
RELATED: When CAR T-Cell Therapy Isn’t Right for You
WATCH: The Value of CAR T-Cell Therapy for Patients.
The entire process involved in getting CAR T-cell therapy can take a few weeks. It starts by drawing your blood and separating out the T cells.
Then, using a virus modified to be harmless, the T cells are genetically engineered to produce proteins called chimeric antigen receptors (CARs) on their surface. These receptors will enable the cells to recognize and attach to a matching protein, called an antigen, on the tumor cell just as a key fits into a lock. The process primes the T cell to “recognize the cancer and to fight it,” Dr. Vose says.
Next, the modified cells are multiplied into the millions in a laboratory. You’ll need a lot of them to fight your cancer.
The CAR T cells are specific to your cancer. For example, some types of lymphoma cells have the antigen CD19 on their surface. CAR T-cell therapies for those cancer types only target the CD19 antigen.
A few days before the actual infusion, you’ll get chemotherapy to clear out some of your own immune cells and prime your body to receive the CAR T cells. This will help the CAR T cells work better. Finally, the modified T cells will be infused back into your body to hunt down the cancer.
What’s exciting about this treatment is that medical research has shown response rates of between 80 and 100 percent. “It’s really unprecedented. This is something we had never seen before for patients who have had six or seven prior lines of therapy,” Dr. Nina Shah, a hematologist with the University of California San Francisco Medical Center, tells SurvivorNet.
CAR-T Cell Therapy Side Effects
CAR T-cell therapy offers patients tremendous hope, especially when the cancer they’re battling has been resistant to other treatments or has come back following treatment. However, it comes with some side effects you should consider with your care team.
“One of the side effects that you may hear about with CAR T-cell therapy is something called neurotoxicity,” Shah said.
WATCH: CAR T-Cell Therapy Side Effects
The word “neuro” refers to your brain and nervous system and the neurons, or nerve cells, that transmit messages to and from your brain and body. “Toxicity” describes the treatment’s potentially harmful effects. Symptoms of neurotoxicity can range from mild to severe. With a mild case, you may feel a little fuzzy or confused.
In rare cases, neurotoxicity can cause seizures, reduced awareness, and even coma. It’s important to tell your doctor if you begin experiencing any unusual symptoms after starting treatment.
How Much Does CAR-T Cell Therapy Cost Patients?
Though Medicare and some private health insurance companies do cover the cost of CAR T-cell therapy for people who qualify, they may not pay for everything. You could still be responsible for co-pays for visits or medications, for example. If those leftover costs are high or you’re uninsured, this treatment could be out of reach.
“These therapies are very expensive, in the order of $400,000 to $500,000 just for the product, just for the T-cells,” Dr. Thomas Martin, a hematologist at the University of California San Francisco Medical Center, tells SurvivorNet. Add to that the cost of all the staff and support needed to administer your treatment and care for you afterward, which can add several hundred thousand dollars more to the total cost. “All the hospital stays, and the nursing costs and the doctor’s costs and the antibiotic costs and transfusions, and all the things that are associated with it come to quite a bit of an expense,” he says.
CAR T-cell therapy is one treatment you need to enter into fully aware of how much you’ll owe. Your cancer center should have someone on staff, such as a patient navigator, to explain your share of the costs before you decide to have this therapy. “It’s worthwhile for us to do the financial cost assessment for each individual person to see how much it might potentially cost for them,” Dr. Martin says.
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