CAR T-cell Therapy for Multiple Myeloma at Sheba Medical Center
CAR T-Cell Therapy for Multiple Myeloma
Multiple myeloma may not be a common malignancy, but it is the most prevalent plasma cell cancer. CAR T-cell therapy is an innovative treatment that is reshaping the landscape of multiple myeloma care, offering newfound hope to many affected by this challenging condition.
What is multiple myeloma, and how does it develop?
Multiple myeloma, a cancer originating in plasma cells, is characterized by the uncontrolled proliferation of certain immune system cells. While its exact cause remains unclear, risk factors include age, with most cases diagnosed in those over 65, and sex as men are more susceptible. A family history of multiple myeloma or related conditions can also increase risk, as can a precursor condition called monoclonal gammopathy of undetermined significance (MGUS). MGUS involves the presence of abnormal plasma cells and M proteins in the blood, but often does not cause symptoms. As multiple myeloma advances, symptoms such as bone pain, fatigue, kidney problems and a weakened immune system may manifest. Additionally, complications like bone damage, kidney dysfunction and anemia can arise, necessitating prompt diagnosis and intervention. Understanding the development, risk factors, symptoms and complications of multiple myeloma is vital for prompt identification and effective treatment, ultimately improving patient outcomes and quality of life.
What is CAR T-cell Therapy?
CAR T-cell therapy, or chimeric antigen receptor T-cell therapy, is an innovative and groundbreaking approach to cancer treatment. This cutting-edge therapy involves a multi-step process that begins with the collection of the patient’s own T-cells, a type of immune cell, which are then meticulously engineered in a laboratory. These specially modified T-cells are transformed into cancer killers capable of recognizing and targeting cancer cells with precision.
Once these genetically modified CAR T-cells are ready, they are reintroduced into the patient’s bloodstream through a single infusion. Remarkably, this single infusion is often sufficient because the CAR T-cells continue to multiply and persist in the body, tirelessly seeking out and attacking the cancerous cells.
Traditionally, CAR-T therapy was primarily utilized for treating lymphoma and acute lymphocytic leukemia. However, it is now being offered to multiple myeloma patients. Researchers at Sheba, led by the globally renowned Prof. Arnon Nagler, have invested substantial effort into engineering CAR T-cells specifically tailored to target myeloma cells.
How does CAR T-cell therapy fight multiple myeloma?
CAR T-cell therapy capitalizes on the multiple myeloma patient’s own immune system to combat this challenging malignancy. The key to its success lies in the precise genetic modification of T-cells, a vital component of the immune system, to target multiple myeloma.
Researchers have meticulously engineered these T-cells to express a chimeric antigen receptor (CAR) on their surface, which is specifically designed to target the B-cell maturation antigen (BCMA). BCMA is a protein that is abundantly present on the surface of multiple myeloma cells, making it an ideal target.
Once these modified CAR T-cells are reintroduced into the patient’s bloodstream they become vigilant “cancer killers.” Not only do they recognize myeloma cells by their distinctive BCMA markers, but they also engage with them, initiating a powerful immune response that leads to the destruction of the malignant cells.
What makes CAR T-cell therapy particularly promising for multiple myeloma treatment is its potential effectiveness in patients who have exhausted other treatment options. Even those who have undergone several rounds of conventional therapies without lasting success can find renewed hope in CAR T-cell therapy.
Before administering CAR T-cell therapy, a thorough evaluation is conducted to identify suitable candidates. Typically, individuals who have completed conventional treatments but continue to experience disease progression are considered prime candidates.
It’s worth noting that CAR T-cell therapy for multiple myeloma is a highly specialized and personalized treatment, available at select medical centers around the world, including Sheba Medical Center. The tailored and holistic approach taken by experts at Sheba ensures that patients receive comprehensive care, addressing both their unique medical needs and overall wellbeing throughout the treatment process.
What are the possible side effects of CAR T-cell therapy?
CAR T-cell therapy represents a promising advancement in cancer treatment, but it also carries the potential for side effects, some of which can be significant. These side effects largely stem from the intense immune response triggered by the modified T-cells and the subsequent impact on the body. Common side effects include:
Cytokine Release Syndrome (CRS)
CRS is CAR T-cell therapy's most common side effect. It occurs when the activated T-cells release a surge of cytokines (immune signaling molecules), leading to symptoms such as fever, low blood pressure and organ dysfunction.
Some patients may experience neurological side effects, including confusion, delirium, seizures and other neurological symptoms.
Low Blood Cell Counts
CAR T-cell therapy can lead to a drop in red blood cells (anemia), white blood cells (neutropenia) and platelets (thrombocytopenia). Infections: Treatment can result in a weakened immune system that makes patients more susceptible to infections.
Treatment can result in a weakened immune system that makes patients more susceptible to infections.
CAR T-cell therapy can affect various organs, including the heart, liver and kidneys, potentially causing dysfunction.
Tumor Lysis Syndrome (TLS)
Rapid destruction of cancer cells can release their contents into the bloodstream, leading to electrolyte imbalances and kidney problems.
It’s important to note that the severity of these side effects can vary from person to person. At Sheba, our medical teams closely monitor patients during and after CAR T-cell therapy, and interventions such as medications to manage side effects are available.
CAR T-cell therapy at Sheba
What is the success rate of CAR T-cell therapy at Sheba?
CAR T-cell therapy at Sheba has demonstrated remarkable success rates, placing it among the leaders in the treatment’s application. While success rates can vary depending on the specific type of cancer and patient, the results achieved at Sheba are highly promising:
For young children undergoing CAR T-cell therapy at Sheba, success rates are impressive at around 85-90%.
Adolescents have also experienced favorable outcomes, with a success rate of approximately 80%.
Among the general population of adults receiving CAR T-cell therapy at Sheba, the success rate remains high at approximately 70%.
These results are a testament to the expertise and dedication of the medical professionals at Sheba, as well as the cutting-edge nature of CAR T-cell therapy.
It’s important to note that CAR T-cell therapy is continually evolving, and ongoing research aims to further improve its success rates and expand its application to various other cancer types.
Why should you choose Sheba for CAR T-cell therapy?
Following are a few key reasons to choose Sheba Medical Center for CAR T-cell therapy for multiple myeloma:
Choosing Sheba for CAR T-cell therapy for multiple myeloma not only ensures access to advanced treatment, but also guarantees comprehensive and patient-centered care from a team of experts dedicated to improving outcomes and enhancing the overall wellbeing of individuals facing multiple myeloma.
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