Chimeric antigen receptor T-cell therapy, or CAR-T therapy, is a treatment that helps your T-cells fight certain types of cancer.

Your T-cells are the parts of your immune system that recognize and help kill foreign cells. CAR-T therapy gives your T-cells the right receptors to bind to cancer cells, so your immune system can destroy them.

CAR-T therapy is only used for blood cancers, but there is much research being done to expand its use. Learn more about how this treatment works, its benefits and risks, and the outlook for CAR-T therapy.

T-cells are part of your immune system. They bind to foreign cells, which are not recognized by your body. Some T-cells destroy the foreign cells, while other types signal the rest of your immune system to destroy them.

“Each type of T-cell bonds to a single type ofProtein T-cells with certain receptors are needed to fight cancer cells. The cancer cell’s specific cancer cell protein is the subject of the specific cancer cell’s receptors. CAR-T therapy is a method of making cells to fight cancer.”

Making T-cells involves a number of steps.

  1. T-cells are collected from the body.
  2. The chimeric antigen receptors are produced by your T-cells in a lab, when their genes are changed to make them specific to your cancer. T-cells can bind to cancer cells.
  3. New T-cells are infused back into your bloodstream after the lab grows lots of them.
  4. You may also get low dose chemotherapy before your infusion to lower the number of other immune cells you have and allow T-cells to work better. According to 2021 research, your dose of T-cells will be carefully balanced to be as therapeutic as possible while limiting toxicity.
  5. After your infusion, the CAR T-cells bind to your cancer cells and destroy them. While this happens quickly, 2022 evidence suggests the CAR T-cells can continue to destroy cancer cells for months after the infusion.

“CAR-T therapy is not approved for first-line treatment of cancer. You have to try at least two treatments that don’t work before you try CAR-T therapy.”

It is only approved for blood cancers like leukemia and lymphoma.

CAR-T therapy can be used to cure people whose blood cancer has not responded to other treatments. CAR-T therapy is often an effective option.

CAR T-cell therapy response rates

According to the National Cancer Institute, response rate refers to the percentage of people whose cancer shrinks or disappears after treatment. In a 2020 research review, overall response rates for different cancers when treated with CAR-T include:

  • Relapsed/refractory diffuse large B-cell lymphoma: 52 to 82 percent
  • B-cell acute lymphoblastic leukemia: 80 percent
  • Chronic lymphocytic leukemia/small lymphocytic lymphoma: 82 percent

Many people in these clinical trials went into complete remission.

CAR-T therapy has many benefits, but it also has some risks.

  • Treatment not working. Very few treatments work 100 percent of the time. It’s possible that CAR-T therapy won’t kill all your cancer cells. And because it’s often used as a last resort, you may not have other options if CAR-T therapy doesn’t work.
  • Relapse. Your cancer can come back even if the treatment works at first. How likely this is depends on your overall health and your type of cancer, so this can’t always be predicted. But 2020 research suggests that certain types of cancer, such as large B-cell lymphoma, seem more likely to come back after CAR-T therapy.
  • Side effects. There are also many potential side effects of CAR-T therapy, and some can be serious.
  • Lack of data. The first CAR-T therapy was approved in 2017. This means there’s still limited data on the long-term effects of the treatment, including its overall effectiveness.

CAR-T therapy can have severe side effects but they usually get better with treatment.

If you have any of the symptoms, contact a doctor.

Many of these are symptoms of mild cytokine release syndrome, also known as CRS or cytokine storm. This is a common side effect of CAR-T therapy. It occurs when the CAR T-cells multiply in your body and cause your body to make too many cytokines — chemicals that can help T-cells function but also cause severe flu-like symptoms.

There are side effects of severe cytokine release syndrome.

There is a potential severe side effect of CAR-T therapy.

Symptoms include:

Well developed guidelines and protocols exist to diagnose and manage both CRS and ICANS. According to a 2019 review, management uses a combination of steroids and drugs such as tocilizumab (Actemra). Despite proper management, some cases may still be life threatening or fatal.

Other potential severe side effects of CAR-T therapy include anaphylaxis and extremely low blood cell counts.

A 2020 review suggests that “turning off” CAR T-cells after they kill cancer cells can reduce these severe side effects. This research is in its early stages, but there are some promising potential ways to turn off CAR T-cells.

CAR-T therapy can be expensive. The drug is the main cost of treatment.

Axicabtagene ciloleucel (Yescarta) is a CAR-T option approved by the Food and Drug Administration (FDA) for treating large B-cell lymphoma. According to a 2018 study, this treatment costs $373,000. Another CAR-T drug, tisagenlecleucel (Kymriah), costs $475,000.

“These numbers do not include other medical expenses, such as doctor’s appointments, tests, prescriptions, and more. Depending on how long your treatment needs to be, expenses can vary.”

If the treatment is shown to be clinically appropriate for you and the doctor prescribes a medication approved by the FDA, it may be covered by insurance. Private insurance companies cover CAR-T in some way, but the amount they cover can vary.

Beginning on October 1, 2019, the Centers for Medicare and Medicaid Services (CMS) announced that CAR-T was covered by Medicare. The amount covered by Medicare will depend on whether you’ve met your deductible, and other individual factors. Some Medicaid programs also cover CAR-T.

CAR-T therapy can be a very successful treatment for people with blood cancers that have not responded to other treatments.

Treatment can be difficult and can take at least 2 weeks to complete. Many people who have undergone CAR-T cell therapy have added months or years to their lives.

CAR-T is only approved for blood cancers, but there is much research being done on its use for other cancers. The future of this therapy looks very promising, as research is being done on making it safer and more effective.