University of Chicago Medicine became the first site in Illinois to offer a new treatment, CAR T-cell therapy, for patients with relapsed or refractory diffuse large-B cell lymphoma (DLBCL), a type of non-Hodgkin's lymphoma.
The new immunotherapeutic treatment uses the patient’s own lymphocytes, a subset of white blood cells, to fight off cancer in place of the traditional chemotherapy, which is the current standard for most cancer treatments.
“[CAR T-cell therapy] is one of the most significant advances in treatment that I have seen in my career,” said Michael Bishop, MD, professor of medicine and director of UChicago Medicine’s Hematopoietic Stem Cell Transplantation Program, in an email to the Maroon. “It provides options for patients who did not have options or for whom options were very limited or have limited value.”
DLBCL is the most common type of non-Hodgkin's lymphoma that affects the B cells of the immune system. Each year, about 23,000 new cases are seen in the United States and median survival for DLBCL is six months. However, those who undergo the CAR T-cell therapy have significantly higher survival rates and 50 percent of the patients have complete remissions, according to Science Life, a scientific journal at UChicago.
With this therapy, the patient’s lymphocytes are “genetically [modified] by introducing a virus which contains genetic material that is incorporated into the cell’s DNA,” Bishop said.
These genetically modified cells are then returned to the body, where they multiply and kill B cells. Common side effects include flu-like symptoms, blood pressure issues, and neurotoxicity, but they can be controlled with anti-inflammatory drugs, according to Bishop.
Bishop also mentioned that getting UChicago Medicine cleared for this therapy by the U.S. Food and Drug Administration was an intense process, in part because the CAR T-cell therapy involves multiple units of a hospital. It requires a level of collaboration among intensivists and neurologists as well as oncologists and nursing staff who specialize in taking care of patients.
“The University of Chicago has participated in several clinical trials testing this specific form of therapy,” Bishop said. “Our institution has demonstrated the ability to carefully care for these patients and has an infrastructure to support the conduct of such trials.”
Bishop is hopeful for the possibility of future developments with the treatment.
“Newer and more advanced forms are currently being tested or are in development,” Bishop said. “We think that [CAR T-cell therapy] will be moved forward to be used earlier in patients’ treatment courses. It can be applied to multiple forms of cancer.”