Your medical team at Sheba will design a customized CAR T-cell therapy plan to target the specific type of cancer you suffer from. Committed to clear and open communication with every patient, we ensure a lack of ambiguity and tell you exactly what to expect.
Conducting the entire CAR T-cell therapy in-house at Sheba has significant benefits for patient care. With a vein-to-vein time of about 10 days, we have eliminated the need for prolonged bridge therapies necessary to control the disease during the waiting period, which in turn correlates with better patient outcomes. Since there's no need for cryopreservation, the potency and quality of the harvested cells remain intact, enhancing the efficacy of treatment. Additionally, in-house management substantially minimizes the risk of production failures. Altogether, this approach allows for quicker, more efficient and potentially more successful cancer treatment.
The following outline is a step-by-step description of the CAR T-cell therapy process:
This stage involves determining whether you are a suitable candidate for the treatment. We will perform various tests and screenings to evaluate whether CAR T-cell therapy will be beneficial for you. In addition, CAR T-cell therapy can be considered only after at least one prior line of treatment for lymphoma patients and two lines of treatment for leukemia and multiple myeloma patients.
2. T-cell collection
By using a special machine for apheresis, T-cells will be separated from the rest of your blood cells in a process called leukapheresis, and then frozen.
3. T-cell engineering
The T-cells are then sent to our in-house lab, where they are genetically modified to produce CARs on their surface. CARs are proteins that enable the T-cells to identify particular antigens on the surface of tumor cells, transforming them into CAR T-cells.
4. CAR T-cell multiplication
The specially altered T-cells are grown in the Sheba laboratory until there are millions of them in a process that takes several days.
5. Lymphodepleting chemotherapy
A short course of chemotherapy is administered to deplete existing T-cells prior to the CAR T-cell therapy. The purpose of this chemotherapy cycle is to suppress your immune system slightly so that it does not reject the CAR T-cells once they are infused. Lymphodepleting chemotherapy may cause nausea, fatigue, and low blood counts.
6. CAR T-cell infusion
Shortly after chemotherapy, you will be hospitalized so that we can re-infuse the CAR T-cells into your body. This process is performed in a similar manner to a blood transfusion.
7. Hospitalization and monitoring
While you will only receive a one-time infusion, you may need to stay in the hospital for a few weeks so our doctors can monitor your condition closely and manage any side effects as needed. Typically, it takes about two to three months to recover. Following discharge, should any side effects arise, you may be required to return to the hospital.
8. Follow-up care
After undergoing CAR T-cell therapy, follow-up care plays a vital role in ensuring a patient's wellbeing and monitoring treatment outcomes. Regular and comprehensive check-ups will be scheduled to assess the patient's recovery progress and potential side effects. These follow-up appointments typically involve monitoring blood counts, immune system function, and overall health.
Additionally, healthcare providers will keep a close eye on any signs of recurrence or relapse of the targeted condition. Follow-up care also includes addressing and managing any lingering side effects or complications that may arise post-treatment. Patient education about self-monitoring and recognizing warning signs is often provided to empower them in their recovery journey. The ongoing support and communication with the medical team during follow-up care are essential in promoting the patient's long-term health and quality of life after CAR T-cell therapy. Over the next several years, you will return for blood tests, physical examinations and/or bone marrow biopsies as well as PET or CT scans.