CAR T-cell therapy is a form of cell therapy that harnesses the body’s immune system to combat cancer. This revolutionary treatment involves modifying and reprogramming a patient’s T-cells—white blood cells critical to the immune system—to recognise and attack specific cancer cells. The process begins by extracting a patient’s T-cells and genetically engineering them in a laboratory to express chimeric antigen receptors.

Chimeric Antigen Receptors (CARs) are artificial receptors designed to redirect T-cells in the immune system to recognise and target specific proteins or antigens found on cancer cells.

Here’s a simplified breakdown of how CAR T-cell therapy works:

• Collection of T-cells: A patient’s T-cells are extracted from their blood through a process called leukapheresis.
• Genetic modification: In a laboratory setting, these T-cells are modified using a viral vector (a harmless virus) to introduce genes that encode a chimeric antigen receptor (CAR) on their surface. This CAR is designed to recognise specific proteins, called antigens, found on the surface of cancer cells.
• Expansion and modification: The modified T-cells are cultured and multiplied to increase their numbers.
• Infusion back into the patient: Once a sufficient number of these engineered CAR T-cells is obtained, they are infused back into the patient’s bloodstream. The CAR T-cells are now equipped to recognise and target the specific cancer cells they were engineered to attack.
• Targeting and destruction: The CAR on the surface of these modified T-cells helps them recognise and bind to specific antigens on the cancer cells. Upon binding, the CAR T-cells become activated, triggering an immune response leading to the destruction of the cancer cells.
• Proliferation and memory: Some of these engineered T-cells continue to proliferate in the body and persist as “memory” cells. These memory cells may provide ongoing surveillance, offering the potential for long-term immunity against the cancer and reducing the likelihood of cancer recurrence.

This therapy has shown promising results in certain types of leukaemia and lymphoma. However, it’s essential to note that CAR T-cell therapy is a complex and personalised treatment that may have significant side effects, including cytokine release syndrome (CRS) and neurologic toxicity, which can be severe in some cases.