Ask The Nurse // 26th April 2019
Patients and carers often get in touch with the Myeloma Infoline and Ask The Nurse services to learn more about research on new and improved treatments for myeloma that is taking place worldwide. One treatment we often get asked about is CAR-T cells. CAR-T cells have been in the news lately because the National Institute of Health and Care Excellence (NICE) has approved the use of CAR-T cells to treat non-Hodgkin’s lymphoma (Yescarta®) and acute lymphoblastic leukaemia (Kymriah®). Therefore, this month’s blog covers some of the questions we have been asked about CAR-T cells.
What is CAR-T cell therapy?
Chimeric Antigen Receptor T cells (CAR-T cells) are a new type of treatment being investigated for myeloma. This treatment option is different from other anti-myeloma drugs as they are made from immune cells, known as T-cells, that have been modified to identify and kill specific cancer cells. CAR-T cells are made by collecting T cells from the patient and genetically modifying them in a lab. They are then given back to the patient as an infusion in a process known as adoptive T cell transfer.
What are T cells?
T cells are a type of white blood cell that are a key component of the immune system. They circulate around the body looking for any potentially harmful, infected or abnormal cells (e.g. cancer cells). Every cell in our body has a number of different proteins on its surface in various quantities, sometimes referred to as receptors or markers. The presence or absence of certain protein markers allows T cells to differentiate between harmful and healthy cells. Once the T cell identifies a harmful cell, it attaches to the cell (using the protein marker) and either kills the harmful cell directly or sends out a signal to the immune system to kill the cell.
How do CAR-T cells work?
CAR-T cells are T cells that have been designed to target a specific protein marker known to be present on cancer cells. Therefore, CAR-T cells work just like a normal T cell but with a specific target in mind.
Are there any CAR-T cells being developed to treat myeloma?
There are over 10 different types of CAR-T cells being developed to treat myeloma. However, these treatments are still in the early stages of development. Most of the CAR-T cells being developed to treat myeloma target a protein marker called BCMA.
The results from clinical trials have shown promise with good response rates and manageable safety. However, the duration of response is less than observed in other types of cancers.
Are there any CAR-T cell treatments available in the UK?
CAR-T cell therapy is not routinely available for myeloma patients in the UK. There are some clinical trials evaluating CAR-T cell treatment for myeloma in the UK. Clinical trials have strict recruitment criteria and at the moment most CAR-T trials are only suitable for high-risk or heavily pretreated relapsed and/or refractory (not responding to treatment) myeloma patients.
For more information download the “Adoptive T cell transfer and CAR-T cell Horizons Infosheet”. You can also find out more about myeloma drugs in development by looking at our “Myeloma Drug Finder” or our “Horizons Infosheets”
The Myeloma Information Specialist Team