Chimeric antigen receptor (CAR) T-cell therapy is a type of immunotherapy. It uses the body’s own immune system to fight cancer, using genetically modified immune cells to target and kill cancer. This is an innovative treatment for certain cancers. It may be a treatment option for patients who have certain blood cancers or multiple myeloma where other therapies are not working. While this therapy has shown remarkable results, it does not always work. Here is what happens if CAR T-cell therapy fails.
Why CAR T-Cell Therapy Might Fail?
In some cases, the cancer may not respond well to treatment, or the tumor may recur later on in life. Due to this, it may fail. Some of the reasons behind CAR T-cell therapy failure are:
Cancer Resists the Therapy
Certain cancers undergo genetic or molecular changes, leading to the loss or alteration of the markers (antigens) that CAR T-cells are designed to recognize. Additionally, the tumor may suppress immune activity, further aiding the cancer in resisting treatment.
T-Cells Lose Power
CAR T-cells, despite being engineered for enhanced cancer-fighting capabilities, can experience a gradual decline in effectiveness. Over time, these cells may exhaust, losing their ability to proliferate and attack cancer cells. Thus, the CAR T-cells may fail to kill the cancerous cells completely, resulting in disease progression.
Incomplete Response
While CAR T-cell therapy often shows promising results, it does not always achieve complete remission. In some cases, the therapy may significantly reduce the tumor burden but fail to eliminate all cancer cells. These residual cancer cells, even in small numbers, can remain dormant or slowly proliferate, eventually leading to disease recurrence.
Cancer Comes Back
A relapse after an initial successful response to CAR T-cell therapy is a significant concern. This recurrence can occur due to several reasons, including the survival and subsequent growth of residual cancer cells. These cells may resist future CAR T-cell attacks or flourish in a changed immune landscape created after the initial treatment. Additionally, the re-emergence of cancer may be fueled by new genetic mutations or the activation of dormant cancer cells, leading to a more aggressive and treatment-resistant form of the disease.
If CAR T-cell therapy is unsuccessful, then you and your patient care team will work together to evaluate the next steps. This may vary from patient to patient, depending on their healthcare requirements.
What If CAR T-Cell Therapy Fails? The Next Step
There is no specific established first-line treatment after CAR T-cell therapy failure. The decision-making for these patients is very much physician-dependent and influenced by patient factors. Some things that your doctor may try include:
Re-Treatment With CAR T-Cells
Doctors might try another round of CAR T-cell therapy. They could use a new design or target a different marker on the cancer cells.
Switching to Other Immunotherapies
Other immunotherapy options like checkpoint inhibitors or bispecific antibodies may help if CAR T-cell therapy does not work.
Chemotherapy or Radiation
Standard cancer treatments like chemotherapy or radiation therapy might still be effective.
Clinical Trials
Patients can explore clinical trials for new and experimental therapies. These trials might provide access to cutting-edge treatments.
What Should Patients Do?
- Stay in touch with your healthcare team for regular monitoring that helps detect cancer early if it returns.
- Consider genetic testing, as it provides insights into why the therapy failed.
- Consult with more experienced cancer specialists or larger cancer centers to have more treatment options.
To Conclude
A failed CAR T-cell therapy is not the end of the road. Cancer treatment is evolving rapidly and new treatment options are constantly emerging. Your oncologist will discuss all possibilities to ensure you remain on the best path for your condition.
Consult EdhaCare if you are looking for CAR T-cell therapy for your cancer treatment. We will get you in touch with the best oncologist skilled in performing the therapy. Additionally, we will assist you in every step of your treatment journey, including but not limited to medical VISA, air bookings, accommodation, air ambulance, leisure travel, etc.
FAQs (Frequently Asked Questions)
How Long Do CAR T-Cells Live?
Although their longevity varies among patients, CAR T-cells can live in the body for months to years. During this period they continue to monitor and attack cancer cells.
What Is The Life Expectancy After CAR T-Cell Therapy Failure?
Life expectancy after CAR T-cell therapy failure depends on the underlying disease, alternative treatments, and patient health. Prognosis can be challenging but varies with factors like new therapies and clinical trials.
Why Does CAR T-Cell Therapy Fail?
CAR T-cells may fail due to tumor resistance, loss of targeted antigens, immune suppression by the tumor, or insufficient persistence of CAR T-cells in your body.
How Many Times Can You Have CAR T-Cell Therapy?
Patients can sometimes receive CAR T-cell therapy more than once. This also depends on factors like the type of cancer, response to the initial treatment, and eligibility for re-treatment.
What Are The Risks of CAR T-Cell Therapy?
The risks of CAR T-cell therapy may include:
- Cytokine release syndrome (CRS)
- Neurotoxicity
- Infections
- Low blood cell counts
- Life-threatening complications in rare cases
What Is The Mortality Rate For CAR T-Cell Therapy?
The mortality rate for CAR T-cell therapy varies but is generally low, with severe complications like cytokine release syndrome (CRS) and neurotoxicity being the primary concerns.