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Is CAR T-Cell Therapy Approved for Follicular Lymphoma?

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Published on August 21, 2020

Follicular Lymphoma and CAR T-Cell Therapy

Dr. John Leonard with the Weill Cornell Cancer Center, explains CAR T-Cell therapy and how it works. Is it currently being used as a treatment for follicular lymphoma? What have studies shown about its effectiveness? Watch to hear the full report.

This is Part 3 of a 4-part segment on Follicular Lymphoma. Watch the full discussion in the series below:

Transcript | Is CAR T-Cell Therapy Approved for Follicular Lymphoma?

What is CAR T-Cell Therapy?

Dr. Leonard:

So T-cells are immune cells that normally fight infections. And we think that in normal cancer therapy or in outcomes of patients with cancer, there are immune cells, these T-cells that are floating around the body and interacting with the tumor, might have something to do with how well the immune system controls the tumor and how the patient does. So the idea of CAR T-cells, CAR means chimeric antigen receptor. The idea is that these blood cells are taken out through a fancy blood donation. The T-cells are separated out of the blood and they are engineered using a special gene insertion technique to better bind tumor cells and to be activated, to be turned on better.

So the idea is that these T-cells are ginned up a little bit to work better and to be more active and to go after lymphoma cells better. The patient then gets some very light chemotherapy to try to make space for the T-cells within the immune cell population. They get their T-cells given back to them. And then the concept is that the T-cells circulate around the body like soldiers on patrol. I don't like army analogies, but that's one way to think of it. And then they find the lymphoma cells in this case and go after it.

So CAR T-cells are FDA approved for aggressive lymphomas, patients with aggressive lymphoma in certain categories, ALL or acute lymphocytic leukemia, a type of leukemia. And more recently, one was approved for mantle cell lymphoma. So a different type of lymphoma. They are not approved for follicular lymphoma, our topic for today, but they've been in clinical trials and had some promising results. I would say that CAR T-cells, it's an involved process. It's something closer to a STEM cell transplant, although it's not quite a STEM cell transplant, it's a little bit different.

And there are some side effects with CAR T-cells because these immune reactions can cause some side effects to the patient. They can cause an immune reaction in the patient where the patient gets fevers and has some side effects associated with it. And there can be a number of other complications that can occur. So typically these are done, again, in other types of lymphoma, but they're being studied now in follicular lymphoma. I would envision in the future that they might be used for patients with follicular lymphoma, a small subset of patients where the disease has come back and they need other treatment options.

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