CAR-T Information

I've across two very recent sources of information  about CAR-T that I'd like to share with you.

As I'm sure you know, CAR-T is a blood cancer treatment, and it's one that is getting a lot of attention lately. CAR-T stands for Chimeric Antigen Receptor T-cell. A T-cell is a part of the immune system. T-cells track down and fight infections (like viruses or bacteria) in the body. But they don't fight cancer cells. So to create CAR-T, some of a patients T-cells are removed from her body, and then changed in a laboratory so they will recognize cancer cells the same way they would recognize other invaders like viruses and bacteria. then they are put back into the patient, and they do their work.

(Personally, I really like that it's called "chimeric," which comes from Greek mythology. A chimera is a monster with a lion's head, a goat's body, and snake for a tale. I always thought that was a cool monster. The Chimeric Antigen Receptor does the same thing, squishing a few different parts into one cell, so it can find and attach to cancer cells and then attract T cells to the cancer cell. But it's a good monster.)

CAR-T therapy is one of those treatments that get oncologists very excited. It works for a lot people (including a couple of readers of this blog), though not for everyone. I read recently that about one-third of patients will have a long-lasting remission with CAR-T (including those two readers), one-third will have a shorter remission (maybe a year), and one-third will not get any remission. My own oncologist is one of those experts who is excited about it, and thinks that in about 5 years, we'll see a much higher effectiveness rate.

Like all treatments, CAR-T has side effects, including Cytokine Release Syndrome, in which the body reacts to so many cells being killed off at once. It can be dangerous, even deadly, though doctors seem to be doing a much better job of expecting this side effect and dealing with it right away. CAR-T can also cause some long-term nerve problems.

And right now, it is only approved in the U.S. for patients with aggressive blood cancers, including Transformed Follicular Lymphoma.

That's a quick look at the basics. Now, those two sources.

The first is a British documentary called War in the Blood, which is running on the British TV station BBC2. I follow a lot of folks in that part of the world on Twitter, and they are all very excited about this documentary. It follows two blood cancer patients who receive CAR-T, and it sounds like an amazing and uplifting piece of work.

Unfortunately for me, the link above will only let people in the UK watch online (and on BBC2). So all of you residents of the UK, please let us know if you've watched the documentary, and what you thought of it. And if anyone outside the UK has found a way to watch it online, or knows of when it might be on TV elsewhere (maybe BBC America?), let us know that, too. (In the meantime, I'll just go to BBC America and happily watch whatever Idris Elba show happens to be on.)

The second source of information is much more accessible: The local radio show Yale Cancer Answers just did an episode on CAR-T, and it is available online. You can either listen to the hour-long show, or read (or translate) a pdf of the transcript.

This link will take you to all of the Yale Cancer Answers shows, listed by date. The CAR-T show is from July 7, 2019.

The show is sponsored by the Yale Cancer Center, which is where I see my oncologist. The expert who talks about CAR-T is Dr. Iris Isufi (she is not my doctor, though she oversees a lot of the clinical trials at the hospital, and so is probably the most up-to-date person on new treatments at Yale). The show is meant for a non-medical audience, so they explain things very simply. I think it's as good an introduction to CAR-T as you'll find anywhere.

Of course, if you're looking for ongoing information about CAR-T, I highly recommend the blog CAR-T and Follicular Non-Hodgkin's Lymphoma, written by those two readers I mentioned above, Ben (who received CAR-T himself), and William (who is actually a caregiver for his wife, a CAR-T recipient).

Good stuff.

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UPDATE 7/16/19: "War in the Blood" is now available on YouTube:
https://www.youtube.com/watch?v=0Nu2qe-Gf_c
Thanks to William for the link.