Chimeric antigen receptor, or CAR T-cell therapy, is a new form of immunotherapy that uses specially altered T cells to directly and precisely target cancer cells.
The immune system is made up of a variety of cells and organs that normally protect the body from infection and cancer. An important component of the immune system are T cells, which have the capacity to hunt down and destroy abnormal cells, including some cancer cells.
Sometimes, cancer cells find ways to evade the immune system; so, the immune system needs to be retrained and enhanced to recognize and attack cancer cells. CAR T-cell therapy is one innovative approach to program and strengthen the immune system to attack some forms of cancer.
After a small portion of a patient's own T cells has been collected from the blood, these cells are re-engineered in a special laboratory so they now carry special structures called chimeric antigen receptors (CARs) on their surface.
When these CAR T cells are reinjected into the patient, they multiply rapidly and these engineered receptors may help the T cells to identify and attack cancer cells throughout the body.
CAR T-cell therapy has been shown to be effective in B-cell acute lymphoblastic leukaemia (ALL) and adult diffuse large B-cell lymphoma (DLBCL).
There are no approved CAR-T treatments worldwide for solid cancers. However, research is underway at Peter Mac in CAR-T cell treatment of solid cancers. Please see ClinicalTrials.gov for further information.
CAR-T is distinct from, and does not replace allogeneic stem cell transplant (from a donor). Find out more information on allogeneic transplants.
The Therapeutic Goods Administration (TGA) has approved Novartis’ CAR-T product Kymriah® (tisagenlecleucel, formerly CTL019). The approved indications are for the treatment of paediatric and young adult patients up to 25 years of age with B-cell precursor acute lymphoblastic leukaemia (ALL) that is refractory, in relapse post-transplant, or in second or later relapse; and for the treatment of adult patients with relapsed or refractory diffuse large B cell lymphoma (DLBCL) after two or more lines of systemic therapy.
CAR T-cell therapy is currently funded for the following indications:
Paediatric and young adult (up to 25 yrs) with Acute Lymphoblastic Leukaemia (ALL) who relapse or do not respond to initial therapy
CAR T for DLBCL is currently being considered by MSAC, however we have a number of active clinical trials for lymphoma and other cancers, see below.
- Axicabtagene Ciloleucel Compared to Standard of Care Therapy in Subjects With Relapsed/Refractory Diffuse Large B Cell Lymphoma (ZUMA-7)
- Efficacy and Safety of Tisagenlecleucel in Adult Patients With Refractory or Relapsed Follicular Lymphoma (ELARA)
- Anti-Lewis Y Chimeric Antigen Receptor-T Cells (LeY-CAR-T) in Patients With Solid Tumours (LeY-CAR-T)
We continue to look for new uses of CAR-T in clinical trials, and we are looking to enrol specific patients into current and upcoming clinical trials in Leukaemia, Lymphoma and some solid cancers. For clinical trial availability email: [email protected] or visit ClinicalTrials.gov.
If you are interested, you should contact your haematologist or oncologist who can organise appropriate referrals.