For many decades, the foundations of cancer treatment have been surgery, chemotherapy, and radiation therapy. But, in recent years, a newer therapy in the form of immunotherapy has emerged, transforming the way we treat certain types of blood cancers. Chimeric Antigen Receptor (CAR) T-cell therapy is a type of immunotherapy that uses the power of the body’s own immune system to fight cancer.

This revolutionary approach has given hope to patients who previously had limited or no options, particularly those battling leukemia, lymphoma, and multiple myeloma.

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How CAR T-Cell Therapy Works?
Unlike traditional treatments such as chemotherapy and radiation, which target cancer cells broadly, CAR T-cell therapy is highly personalized. It modifies a patient’s own immune cells (T-cells) to specifically recognize and destroy cancer cells.

T cells are collected from a patient’s blood and genetically modified in the lab to produce Chimeric antigen receptor (CAR)-T cells which have the capacity to recognize, attack, and destroy targeted cancer cells. The modified T-cells are multiplied in large numbers to ensure they can fight the cancer effectively.

The engineered T-cells are then infused back into the patient, where they seek out and destroy cancer cells.

This one-time infusion has been life-changing for many blood cancer patients, especially those whose cancers have relapsed after multiple rounds of conventional treatments.

Which Cancers Can CAR T-Cell Therapy Treat?

CAR T-cell therapy has been approved for several types of blood cancers, especially those that have relapsed or are resistant to standard treatments.

• Acute Lymphoblastic Leukemia (ALL): Common in children and young adults.
• Diffuse Large B-Cell Lymphoma (DLBCL): A type of aggressive non-Hodgkin lymphoma.
• Mantle Cell Lymphoma (MCL) and Follicular Lymphoma (FL): Rare but challenging cancers.
• Multiple Myeloma (MM): A cancer of plasma cells in the bone marrow.

Benefits of CAR T-Cell Therapy Over Traditional Treatments
CAR T-cell therapy stands out as a next-generation cancer treatment over conventional cancer treatments due to its various advantages. CAR T-Cell therapy is highly personalized, as it uses the patient’s own cells, reducing the risk of rejection. Unlike chemotherapy, which affects both cancerous and healthy cells, CAR T-cells attack only cancer cells. For many patients, CAR T-cell therapy has led to long-term remission, even when other treatments like chemotherapy had failed. Some patients remain cancer-free years after a single infusion.

Challenges and Side Effects
While CAR T-cell therapy offers remarkable benefits, it is not without challenges. This therapy is expensive and available only in specialized centers. There can be an immune reaction called Cytokine Release Syndrome (CRS) that can cause fever, low blood pressure, and organ damage. Some patients experience neurological side effects like confusion, seizures, or memory loss. However, cancer specialists closely monitor patients after treatment to manage these side effects effectively.

The Future of CAR T-Cell Therapy
Scientists are working to make CAR T-cell therapy more effective, safer, and accessible. Research is exploring its potential use in solid tumors like breast and lung cancer. Efforts are also underway to reduce costs and make the treatment more widely available. Future developments, such as “off-the-shelf” CAR T-cells from healthy donors, could eliminate the need for personalized cell collection, making treatment faster and more affordable.

A New Era in Cancer Treatment
CAR T-cell therapy represents a paradigm shift in cancer care. For many patients, it has been the difference between hope and despair, life and death. While challenges remain, ongoing research continues to improve this life-saving therapy, bringing us closer to a future where cancer is no longer a life-threatening disease. With healthcare facilities like Manipal Comprehensive Cancer Centre at Manipal Hospital Old Airport Road ensuring patients receive the best possible outcomes with the latest in cancer treatment technology, this revolutionary therapy is becoming more accessible, bringing us closer to a future where cancer is no longer a life-threatening disease.

(This article is authored by Dr. Mallikarjun Kalashetty, Consultant – Haematology, Haemato Oncology & Bone Marrow Transplantation, Manipal Hospital Old Airport Road, Bengaluru.)