CAR T-cell therapy in autoimmune disease infographic
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What is CAR T-cell therapy?
Chimeric antigen receptor T-cell therapy (CAR T-cell therapy) is a treatment initially developed to harness the patient’s own immune system to more effectively fight cancer.¹
Autologous CAR T-cell therapy is developed for each individual patient and involves reprogramming the patient’s own immune system cells to manufacture a product which is used to target some forms of cancers, and most recently autoimmune diseases.
CAR T-cell therapy is a specialist treatment and it is only possible to have this treatment at a registered CAR T-cell therapy hospital with healthcare professionals who have the right expertise.²
A specialist nurse collects the T-cells which are sent to a facility where CARs are added. For people with autoimmune disease, CAR T-cell therapy is currently only available for people with certain diseases in clinical trials, subject to eligibility criteria.³
CAR T-cell therapy: cancer VS autoimmune
CAR-T therapy was originally developed to target malignant cancer cells and to treat B-cell-derived blood cancers, such as leukemia and lymphoma. It produced dramatic and sometimes long-lasting remissions in patients who have exhausted standard therapies.⁴
The potential use of CAR T-cell therapy is being explored for autoimmune diseases, such as lupus, systemic sclerosis, stiff person syndrome and generalised myasthenia gravis, to name a few.⁵ For both certain cancers and autoimmune diseases, the same target is found on B-cells, including those that drive illness. CAR T-cells can profoundly remove B-cells even deep within tissues. Researchers hope this deep B-cell depletion can allow for an “immune reset”.
The process of CAR T-cell therapy
Step 1 The patient’s blood is taken through a process called apheresis. The T cells are collected, and the other parts of the blood are returned to the patient’s body.
Step 2 The patient’s T cells are sent to a manufacturing facility where CARs are added. They are now CAR T cells designed to find and destroy specific B cells, including unhealthy ones that can contribute to autoimmune disease.
Step 3 Before receiving CAR T cells, the patient receives a pre-infusion, short course of low dose chemotherapy treatment to help prepare their body for treatment. This is often referred to as conditioning.
Step 4 The patient’s CAR T-cells are returned to their body as a potentially one-time infusion. Depending on the specific CAR T and an individual’s response they may need a repeated dose over time, or retreatment with a different target.
Step 5 After the infusion of CAR T-cells, the patient is closely monitored for side effects by the healthcare team at the clinical trial site. Long-term care may be overseen by the healthcare provider who originally referred the patient for CAR T-cell therapy. Patients should be monitored over the long term for disease control and potential side effects.⁴
References
[1] bmtinfonet.org/video/car-t-and-other-immunotherapies
[2] cancerresearchuk.org/about-cancer/treatment/targeted-cancer-drugs-immunotherapy/car-t-cell-therapy
[3] england.nhs.uk/commissioning/spec-services/advanced-therapy-medicinal-products/car-t-therapy
[4] medicine.yale.edu/news-article/car-t-therapy-cancer-autoimmune-diseases
[5] Schett G, et al. Lancet. 2023; 402:2034-2044.
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This digital spotlight has been made possible with financial support from Kyverna Therapeutics, Inc.
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