CAR T cell therapy

CAR T cell therapy was pioneered right here at Penn Medicine. Our groundbreaking research continues as we develop more CAR T cell drugs, expanding their use to treat a variety of cancers and noncancerous conditions like autoimmune diseases. We’re leading the way in this evolving field of immunotherapy, providing novel options and new hope for those with tough-to-treat conditions.

It all begins with T cells. T cells are white blood cells that find and suppress illness and infection throughout the body. These cells work with the body’s own immune system to recognize and remove abnormal antigens (proteins or molecules) that are foreign to the body. Sometimes, when cancer cells have antigens that the body doesn’t identify as abnormal, the body doesn’t signal T cells to remove them, allowing the cancer cells to spread. This is when we put CAR T cells to work. Chimeric Antigen Receptor (CAR) T cell therapy is a type of cancer immunotherapy treatment that uses modified T cells to target cancer cells without harming the healthy cells nearby.

Penn Medicine scientists were the first to discover this innovative method of using the body’s immune system to treat cancer, leading to the first FDA-approved CAR T cell treatment in 2017. We’ve continued to research ways to improve and extend the use of CAR T cell therapy for cancer and other chronic conditions. Our commitment to enhancing and broadening options for cancer treatment means our patients are first to benefit from new therapies and the clinical trials that make them possible.

CAR T cell therapy is a customized treatment that can vary in terms of timing and duration. During a typical CAR T cell therapy treatment, you can expect to first have blood collected from a vein in your arm or central line, if you have one. Once the blood is taken, the process for engineering T cells begins. The blood is processed through a machine that separates your T cells from the rest of your blood cells. After that, our scientists send your T cells to a lab and modify them genetically, creating customized chimeric antigen receptor T cells. These new T cells are equipped with a special receptor that helps them identify and destroy cancer cells.

Before the CAR T cells are put back into your bloodstream, you will undergo lymphodepleting chemotherapy. This procedure removes some of the existing T cells in your body to make room for and prepare your immune system for the infusion of the CAR T cells. The process takes place in an outpatient infusion center, in the hospital, or a combination of both. Our experts from the Cell Therapy and Transplant Program will be there to guide you through the entire process and help you understand what to expect before, during, and after the procedure.

Transfusion-free CAR T

At Penn Medicine, we are proud to offer innovative transfusion-free CAR T cell therapy as part of our commitment to providing advanced treatments tailored to the needs of our patients. This option is especially beneficial for patients who prefer to avoid blood transfusions, including those with religious convictions or personal preferences. Our Transfusion Free Medicine program has over 20 years of experience and a strong track record of success in performing procedures without blood products.

Patients who undergo standard CAR T cell therapy often receive blood transfusions to manage side effects such as anemia and low platelet count. These blood transfusions help maintain adequate blood counts and support the patient’s overall health during the treatment process. However, with transfusion-free CAR T, our care team avoids the use of blood products through alternate strategies to manage blood counts and support the patient. Some of the alternative methods we use to compensate for the lack of blood transfusions include: 

• Growth factors: Medications that stimulate the production of red blood cells and platelets 
• Antifibrinolytics: Drugs that help prevent the breakdown of blood clots, reducing the risk of bleeding 
• Vitamin K: Natural supplement that supports the blood coagulation process and prevents bleeding 
• Minimizing blood loss: Techniques, such as minimizing blood draws to reduce blood loss during treatment

Patients eligible for transfusion-free CAR T therapy are carefully selected based on their ability to tolerate the treatment without blood transfusions. Our care team will provide intensive monitoring and supportive care to manage any complications that may arise, ensuring the safety and effectiveness of the treatment. While both standard and transfusion-free CAR T cell therapies boost the body’s ability to target cancer, our program works closely with patients to respect their convictions and provide effective alternative treatment options.

CAR T cell therapy at Penn Medicine

Penn Medicine scientists were the first to discover this innovative method of using the body’s immune system to treat cancer, leading to the first FDA-approved CAR T cell treatment in 2017. We’ve continued to research ways to improve and expand the use of CAR T cell therapy for cancer and other chronic conditions. Our commitment to enhancing and broadening options for cancer treatment means our patients are first to benefit from new therapies and the clinical trials that make them possible. Our scientists envision the future of CAR T therapy with unlimited potential to treat many conditions and diseases, bringing hope to patients who previously had few to no treatment options.

There are many benefits for patients who receive CAR T cell therapy at Penn Medicine. 

• Options for even the most complex cancers: We offer the most advanced immunotherapy options, enabling us to treat patients who may have had unsuccessful treatment elsewhere. 
• Extensive experience: Our physicians and nurses have years of experience with CAR T cell therapy. They understand which therapy approach will work best for your unique cancer type and can detect potential side effects and complications early for fast intervention. 
• Personal attention and education: Treatment decisions are complex and personal. Our physicians and nurse navigators will educate you about the treatments that can help you and their risks. We’ll answer any questions you may have and make sure you’re prepared.