CAR T-cell therapy

University of Iowa Holden Comprehensive Cancer Center is the first and only provider in Iowa to offer CAR T-cell therapy, an advanced treatment that uses your own immune system to fight cancer.

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University of Iowa Holden Comprehensive Cancer Center is leading the way in providing the most advanced treatments. Holden is among the first sites in the nation, and the first in Iowa, to treat patients with CAR T-cell therapy.

CAR T-cell therapy is an immunotherapy that can treat types of lymphomas, leukemias, and myeloma by helping the body’s immune system recognize and attack cancer cells. This treatment uses genetically improved versions of your own white blood cells to find and kill cancer cells in your body.

As the state's leader in cancer research, Holden is working to expand the use of CAR T-cell therapy in the treatment of various cancers through clinical research trials. This includes multiple open clinical trials using CAR T-cell therapy to treat solid tumors.

How CAR T-cell therapy fights cancer

White blood cells, also known as T-cells, protect the body from disease and infection, but cancer cells survive by avoiding the immune system altogether. CAR T-cell therapy gives the immune system the power to fight cancer by training the T-cells to find and kill cancer cells.

Normally, T-cells move through the bloodstream and perform something like a handshake with other cells. Using this handshake, the T-cell can tell which cells are normal and which cells are dangerous and should be killed. But some cancer cells can hide by appearing to be normal cells during these T-cell handshakes.

To train them, some of your T-cells are collected and modified by adding genes to the T-cells that result in proteins known as chimeric antigen receptors (CAR). This process turns the T-cells into CAR T-cells that have the power to recognize and kill cancer cells that otherwise would be undetectable.

The CAR T-cells also continue to multiply so that even if they kill all the cancer cells, they can continue to search for new cancer cells to help prevent a recurrence of cancer in the future.

The CAR T-cell therapy process

Once you have been deemed eligible for CAR T-cell therapy, your T-cells are collected using a process called leukapheresis. This is very much like donating blood, but in this process, the blood will pass through a machine that only collects the T-cells. The remaining blood is returned to your bloodstream.

The collected T-cells are sent to a laboratory, where they will be converted into CAR T-cells and allowed to multiply into millions more cells than were originally removed from your blood.

To prevent the body from rejecting the CAR T-cells, you will receive a low dose of chemotherapy daily for three days before the CAR-T cells are returned to your bloodstream.

You will then be monitored in the hospital for at least seven days after the infusion. Additionally, you will need to remain within two hours’ travel time of the hospital for four weeks afterward and return regularly for follow-ups.

Who is eligible for CAR T-cell therapy?

Our doctors conduct tests to determine if you could benefit from CAR T-cell therapy.

Currently, CAR T-cell therapy is available for patients with three specific types of cancer:

Adults with certain types of non-Hodgkin lymphoma who have had a relapse or have received two other kinds of treatment that didn’t work
Children and young adults with acute lymphoblastic leukemia (ALL) that didn’t respond to therapy or have relapsed a second time
Adults with multiple myeloma who are not responding to treatment or have had their myeloma return after treatment

We are also researching the use of CAR T-cell therapy to treat other forms of cancer, including multiple clinical research trials using CAR T-cells to treat solid tumors.