Chimeric Antigen Receptor T-cell therapy is a very exciting and new therapy option for lymphoma (and potentially other cancers). As of this writing in March 2017 it is still in phase I and II clinical trials and not approved in any country. Phase I and II trials don't normally attempt to establish the efficacy of a therapy. They mostly deal with safety and dosing and only measure efficacy as a minor goal.
But the early trails for CAR T-cell therapies have been producing some truly amazing results. So just what is CAR T-cell therapy? Well the full explanation is beyond the expertise of this webmaster, but the layman's explanation is this: The remove T-cells from the patients body and then genetically alter them to specifically target the CD19 antigen that is found on lymphocytes. Next the grow LOT and LOTS of those cells in the lab. Next they put them back in the patient. Those modified cells are VERY good at targeting those CD19 antigens and they race around the body killing all the lymphocytes that express it. (nearly all do). Since nearly all B-cell lymphomas express CD19 on their surface this means the lymphoma is very effectively killed.
What is most exciting is that many patients who have had MULTIPLE failed therapies including stem cell transplants, have achieved complete remissions with this therapy. That is a very amazing feat since these patients were out of options and would likely have died.
There are risks. Currently the two primary risks appear to be some significant neurotoxicity which is reversible. The other is cytokine release syndrome (CRS). This is where the dying cancer cells release vast amounts of cytokines which can overwhelm the body and its body to eliminate them.
Since CAR T-cell therapy is still experimental and not approved in any country, all we can do on this page is present some of these studies which are showing such good results. None of these studies have any truly long term results so it is hard to know if these remissions will be durable.
First is an overview of where this is treatment is heading.
Now some studies about the results so far.
Phase 1 Clinical Results of the ZUMA-1 (KTE-C19-101)
Study: A Phase 1-2 Multi-Center Study Evaluating the
Safety and Efficacy of Anti-CD19 CAR T Cells (KTE-C19)
in Subjects with Refractory Aggressive Non-Hodgkin