As the first line of our body’s defenses, the immune system relies on a formidable army of T cells. Their duty is to find and eradicate everything that spreads disease or infection. But unfortunately, the immune system frequently fails to deploy T cells immediately when it comes to cancer.
CAR T cell immunotherapy converts collected T cells into chimeric antigen receptors (or CARs), which bind to malignancies and kill them. But, of course, like any treatment, there are risks and side effects associated with CAR-T therapy. So what more should you know about CAR-T therapy for cancer treatment?
What Is CAR-T Therapy?
Chimeric antigen receptor (CAR) T-cell therapy offers training for the critical T cells to fight cancer by modifying them in the lab to detect and destroy invading cells. Because it includes changing the genes inside T cells to help them target cancer, CAR T-cell therapy is frequently referred to as cell-based gene therapy.
How Does CAR-T Therapy Work?
T cells come from the patient’s blood and are changed by adding a receptor gene in the lab. The change allows the T cells to adhere to a specific cancer cell antigen. The patient is subsequently given the CAR T cells.
Because various tumors have distinct antigens, each CAR is designed to target a unique cancer variant. For example, cancer cells in certain types of leukemia or lymphoma carry an antigen called CD19. Therefore, CAR T-cell treatments for these tumors connect to the CD19 antigen and do not function on tumors that lack it.
What Are the Risks of CAR-T Therapy?
Drugs that activate the immune system to kill tumor cells can lead it to detect and attack the body’s healthy tissues in some people. As a result, some patients receiving immunotherapy such as CAR-T develop inflammation of the inner lining of the colon, the lungs, or heart muscle, among other side effects associated with an overly active immune system.
Many patients who get CAR-T cell treatment have cytokine release syndrome, resulting in a fever, rapid heart rate, low blood pressure, and rash, among other symptoms. The condition is due to the quick and massive release of proteins known as cytokines into the bloodstream from immune cells altered by immunotherapy.
Cytokine release syndrome often develops within hours of an infusion. Most patients have a moderate reaction, but others have more significant attacks. Doctors are learning how to diagnose and treat CRS earlier as they get more expertise with CAR T-cell treatment.
Potential Side Effects of CAR-T Therapy?
CRS is just one potential issue that can come with CAR-T. Some patients experience problems with their nervous system, as well. They may develop side effects such as:
- Confusion
- Agitation
- Seizures
- Tremors
- Aphasia or difficulty understanding and using language
- Loss of consciousness
- Headaches
- Poor balance
Because of the possibility of these adverse effects, adult patients should not drive, operate machinery, or engage in any other potentially hazardous activity for at least several weeks following treatment.
There is also a risk of complications from the treatment, such as allergic reaction, weakening of the immune system, and low blood cell counts. Therefore, patients must be aware of the potential pitfalls of CAR-T so they can notify their care team should they occur.