Cellular Therapy: A Leap Forward In Cancer Care

Cellular therapy, hailed as a breakthrough in cancer care, is not yet widely available in the U.S. But it is offered at Franciscan Health Cancer Center Indiana Blood & Marrow Transplantation in Indianapolis. And it’s changing how doctors treat this often-devastating disease.

For decades, doctors have treated cancer with therapies from outside the body. These treatments have included chemotherapy, radiation and surgery. This new approach treats cancer with tools that originate inside the body.

“Cellular therapy uses the body’s own cells, or cells from another person, a donor, to help fight disease,” said Felix A. Mensah, MD, a cellular therapy specialist with Franciscan Health Cancer Center Indiana Blood & Marrow Transplantation. “With CAR T-cell therapy we can specifically prepare cells to better recognize and attack cancer cells in your body.”

Key Takeaways: Cellular Therapy

• Franciscan Health Cancer Center Indiana Blood & Marrow Transplantation in Indianapolis is one of only a select number of medical centers in the U.S. to offer cellular therapies to treat blood cancers, with treatments for other cancers likely to follow soon. Patients can receive bone marrow transplantation, including transplants from deceased donors when there Is not matched donor, and chimeric antigen receptor (CAR) T-cell therapy.
• Cellular therapies have produced remarkable results for people with blood cancers. CAR T-cell therapy, for example, has helped people in their 80s with lymphoma who did not respond to multiple chemotherapy regimens to achieve complete remission. There is no age limit for this form of curative approach to cancers like lymphoma
• Franciscan Health is small enough to provide patients with personable, patient-centered care, but sophisticated enough to offer the most advanced, innovative therapies available, dual targeting CAR T-cell therapy and allogeneic transplant including deceased donor options.

Rapidly Evolving Treatments

Dr. Mensah is an independent oncologist and hematologist who chooses to practice at Franciscan Health Indianapolis. He’s worked in cellular therapy for more than 10 years. During that time, the field has rapidly evolved.

Today, doctors primarily use cellular therapy to treat blood cancers. These include leukemia, lymphoma and multiple myeloma.

But Dr. Mensah believes cellular therapy holds greater potential. It may be an effective treatment for other malignancies, such as deadly brain tumors like Glioblastoma multiforme and thyroid cancer. And even people with conditions such as lupus may benefit.

“These are all things that are coming,” he said, “and very soon they will be available as standard of care.”

A New Method Of Bone Marrow Transplants

Bone marrow transplants, or stem cell transplants, have the longest history among cellular therapies. Doctors performed the first bone marrow transplant more than 50 years ago.

Normally, bone marrow produces healthy, blood-forming cells. But blood cancers disrupt this process. Bone marrow transplants replace marrow that’s damaged, either by your disease or its treatment. You first receive high-dose chemotherapy or radiation to destroy your cancer. Then, you undergo the transplant.

Doctors can harvest or retrieve new blood-forming cells (stem cells) from your own body (in cases of autologous transplant) or from a donor (when an allogeneic transplant is needed). The donor may be a relative or an unrelated person who’s a genetic match.

Once doctors deem you ready, they infuse you with the stem cells. The cells create new blood cells after reaching your bone marrow.

This treatment is often effective. But it’s not always easy to find a donor. That may soon change.

Clinical trials now offered at Franciscan Health Cancer Center Indiana Blood & Marrow Transplantation are testing how to get stem cells from the bone marrow of deceased donors. This could give new hope to those who have difficulty matching with a donor, particularly minority populations.

Franciscan Health is the first facility in Indiana to offer this option. The treatment is quite new. But according to Dr. Mensah, early results suggest it works and is safe, with “excellent results.”

Cancer-Targeting Treatment

Chimeric antigen receptor (CAR) T-cell therapy is, perhaps, an even more exciting cellular therapy. The FDA approved it in 2017. It’s usually reserved for cases where other treatments have failed.

CAR T-cell therapy involves removing immune system cells called T lymphocytes, or T cells, from your blood. This requires a special machine, somewhat like a dialysis machine.

Doctors send the cells to a lab, where the cells’ DNA is modified. After growing many more of these new cells, the lab returns them. Doctors then infuse the cells back into your body.

“The T cells are ‘trained’ at that specialized lab to recognize a certain spot on cancer cells,” Dr. Mensah said. “They go directly to the cancer cell, attack that spot and destroy the cell.”

Some forms of CAR T-cell therapy can attack cancer cells at multiple spots, which potentially makes this cancer treatment even more effective.

The future for this treatment is especially exciting. Clinical trials have suggested it may eliminate glioblastoma, a deadly form of brain cancer, entirely. And researchers are developing promising CAR T-cell therapies for lung and ovarian cancers, as well, Dr. Mensah said.

One-And-Done With Dramatic Results

T-cell collection to reinfusion takes about three to four weeks. During this period, you may have other treatments for your cancer, such as chemotherapy. This keeps your cancer from advancing while you wait. Once the T cells are reintroduced, you need close follow-up for several weeks, and then periodic check-ins. But that’s it.

“Usually, it’s a one-and-done treatment,” said Dr. Mensah.

Most people see improvement in their cancer within three months. Some even earlier. In many cases, the results are dramatic.

“I’ve had patients who were in their late 80s with lymphoma that did not respond to three separate chemotherapy regimens,” said Dr. Mensah. “Treatment with CAR T-cell therapy led to complete remission.”

Qualifying For CAR T-cell Therapy

Overall, CAR T-cell therapy is easier on your body than treatments like chemotherapy. Most people tolerate it well.

Unlike stem cell therapy, which is restricted to people younger than 75, CAR T-cell therapy is available for people of any age. The main consideration is that you are relatively mobile and strong enough to withstand treatment.

Along with high fever, low blood pressure and confusion, weakness is one of the CAR T-cell therapy’s main side effects. It’s possible to rehabilitate you if the treatment makes you weak. But if you’re weak to begin with, that’s more difficult.

In some cases, the Transplant Optimization Program (TOP) at Franciscan Health may help you get strong enough to undergo the therapy.

Advanced, Attentive Care

You might expect to find cellular therapies only at large academic medical centers. Getting them at Franciscan Health Indianapolis is a bonus.

“We’re small enough to be very personable, but sophisticated enough to have every form of therapy,” Dr. Mensah said.

If you or a loved one has been diagnosed with blood cancer, Dr. Mensah suggests contacting Franciscan Health Cancer Center Indiana Blood & Marrow Transplantation as soon as possible. Self-referrals and physician referrals are accepted.

“We have a dedicated team, a very experienced team, that guides patients and their families through every step of the process,” Dr. Mensah said.

Staff can even work with your insurance provider to verify whether it covers the treatments.

Call (317) 528-5500 or request an appointment with Franciscan Health Cancer Center Indiana Blood & Marrow Transplantation online.