Life-threatening leukemia can now be effectively treated with the advancement of modern multimodal treatment methods. One such treatment is Chimeric Antigen Receptor or CAR T-cell Therapy, a new method that is making breakthroughs in the treatment of complex blood cancers.
The latest World Health Organization (WHO) data published in 2020 reported that the death rate due to leukemia has kept Sri Lanka in the World Rank 35th position. It said that the number of deaths from leukemia in Sri Lanka reached 1,155 or 0.99% of total deaths in 2020. The type of cancer from which most of our Sri Lankan children suffer is leukemia.
CAR T-cell Therapy has been proven successful in the treatment of leukemia and other complex blood cancers. This treatment offers a significant survival advantage compared to conventional chemotherapy, especially for patients whose diseases have relapsed or previously failed to respond to standard treatment.
CAR T-cell Therapy is the latest treatment approved by the U.S. Food and Drug Administration (FDA) and the Singapore Health Sciences Authority (HSA) under a new Cell, Tissue, and Gene Therapy Products (CTGTP) regulatory framework. Parkway Cancer Centre (PCC) is the first private medical centre in Singapore to offer this treatment.
CAR T-cell Therapy treatment, which is a form of immunotherapy, involves extracting T-cells, a type of white blood cells, from the patient’s blood, modifying them in a laboratory, and then re-infusing the modified T-cells (CAR T-cells) into the patient. CAR T-cells detect cancer cells and destroy them by harnessing the body’s own immune response.
CAR T-cell Therapy is approved for the treatment of B-cell Acute Lymphoblastic Leukemia (B-ALL), leukemia in paediatric patients and young adults up to the age of 25, and relapsed and refractory cases. Patients who are responsive to treatment also continue to be stable and free of disease, with 7 out of 10 patients surviving after 2 years.
As it is a highly specialized treatment, the eligibility for CAR T-cell Therapy is assessed based on several factors such as the overall fitness of a patient to receive lymphodepleting chemotherapy, adequate functioning of main organs, the age limit of 25 years, and the absence of serious infections, concurrent cancers and active autoimmune disorders.
Side effects of this treatment include the multisystemic disease called Cytokine Release Syndrome (CRS), immune effector cell-associated neurotoxicity syndrome (ICANS), tumour lysis syndrome, and other complications such as low immunity levels and higher risk of infection. However, many of these side effects can be managed by a highly trained, multidisciplinary clinical care team. CAR T-cell Therapy would make more advancements in the treatment of blood cancers as well as non-haematological cancers in the future.