Hope - Cancer Publication by Karmanos, May 2018

A PUBLICATION OF THE BARBARA ANN KARMANOS CANCER INSTITUTE

MAY 2018

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When Breast Cancer Strikes Young

USING THE BODY TO BEAT CANCER

New treatment uses patient’s own immune system to destroy the disease

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he Barbara Ann Karmanos Cancer Institute in Detroit is now offering an advanced, new treatment that’s giving renewed hope to patients who haven’t responded to standard therapies for recurrent non-Hodgkin lymphoma.

Outcomes tends to be better for patients diagnosed in their 20s and 30s

In the field of oncology, this is a big breakthrough,” said Abhinav Deol, M.D., medical oncologist, Karmanos Cancer Institute and associate professor, Wayne State University School of Medicine.

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Chimeric antigen receptor (CAR) T-cell therapy leverages the power of a patient’s own immune system by modifying their T cells to recognize, attack and destroy cancer cells. This therapy received Federal Drug Administration approval last fall and is available at only a limited number of top cancer centers nationally.

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There for the Patient Every Step of the Way Oncology nurses provide highly-skilled care throughout treatment

CAR T-cell therapy has shown promising success rates for adults fighting diffuse large B-cell lymphoma (an aggressive type of non-Hodgkin lymphoma). In Michigan, this therapy is only offered at Karmanos. “About 80 percent of patients who received the treatment showed an initial positive response,” says Dr. Deol. “Up to 45 percent of patients remained in complete remission a year and a half after treatment.” He added that as more data is available, oncologists hope to see an even longer time in remission.

The therapy begins with the collection of the patient’s T cells. Those are sent to a lab where they’re genetically modified with a CAR gene that recognizes cancer cells. Once the modified cells return to the clinic, the patient undergoes a mild form of chemotherapy before receiving an infusion of the CAR-T cells. As the modified cells mix with the patient’s blood, they activate, multiply and attack the cancer cells. “Since these are the patient’s own immune cells, the body does not reject them,” Dr. Deol says. “These cells are a living treatment that stays in the body to keep the cancer from returning. It’s a one-time treatment that we hope will put many more patients in long-term remission.” Although CAR-T is a very promising treatment, it’s not for everyone. The one-time treatment is expensive and not all health insurances cover this therapy. Among the potential treatment side effects are high fever, fast heart rate, low blood pressure, confusion or seizures. These need to be managed aggressively and with appropriate remedies. Due to the unique side effects associated with this treatment, it is only offered at select few cancer centers that have the experience and expertise to manage them. “This is an exciting time for immune system cancer treatments,” Dr. Deol says. “Ongoing and future research will bring similar therapies for many other types of cancers.”