Treatment

CAR-T cell Therapy

Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine is one of the first centers nationwide to offer the newly approved CAR-T cell therapy called Yescarta.

At the heart of the new therapy are so-called T cells, which are part of a person’s immune system. Typically, T cells fight off disease. However, in cancer patients, T cells lose the ability to recognize and attack cancer cells. CAR-T cell therapy involves extracting a patient’s own T cells and supercharging them to home in on cancer cells and destroy them.

Clinical trials of CAR-T cell therapy have shown what doctors have called remarkable remission rates among adults with non-Hodgkin lymphoma and children with acute lymphoblastic leukemia (ALL). Of every 10 patients who were treated with CAR-T cell therapy on clinical trial after not responding to standard therapies, between four and eight experienced remission for six months to a year. Some patients have remained in remission for several years.

These modified T cells (dubbed CAR-T, or chimeric antigen receptor T, cells) often are referred to as a living drug because they multiply, sometimes by the millions, once in the bloodstream. And like other T cells, they remember what their targets look like, sometimes long after the cancer cells have been destroyed. While long-term data is still being gathered, there is evidence that some CAR-T cells may maintain their active surveillance and ramp up again in response to cancer recurrence.

Because the therapy induces a heightened immune response, there can be a range of side effects, from fever and shortness of breath to kidney failure and seizures. Many of the side effects are manageable, but some are severe and a few can be life-threatening, which is why the first centers selected to administer the new therapy are those, such as Siteman, that have extensive expertise in treating blood cancers.

The U.S. Food and Drug Administration (FDA) has approved CAR-T cell therapy for two types of cancer: large B cell lymphoma in adults and ALL in children. The therapy is available only to patients whose cancer has not responded to standard treatments, including chemotherapy and bone marrow transplantation. It’s expected that CAR-T cell therapy eventually will be approved to treat other types of cancer, including other blood cancers and solid tumors.

Siteman Cancer Center Facts

  • Siteman is one of the first cancer centers nationwide approved to offer CAR-T cell therapy
  • Washington University scientists at Siteman were involved in research and clinical trials that led to development and approval of CAR-T cell therapy
  • On the clinical side, Washington University physicians at Siteman have extensive experience in treating blood cancers. For example, Siteman’s adult bone marrow and stem cell transplant program is one of the largest in the world, performing nearly 500 transplants each year – and more than 7,500 since 1982. Such experience is why Siteman was chosen as one of the first cancer centers to provide CAR-T cell therapy.

Patient Referrals

Siteman offers a team of referral specialists who assist providers seeking CAR-T cell therapy for their patients. To request an appointment, call 314-747-3046 or 877-251-6485 toll free from 8 a.m. to 4:30 p.m. Monday through Friday. Referrals also can be made online through a secure appointment request service at www.siteman.wustl.edu/refer.

To expedite the referral process, our referral specialists may ask you to fax records to us at 314-454-8103.

The mailing address is:

Siteman Cancer Center
Mailstop 90-75-563
4901 Forest Park Ave.
Center for Outpatient Health, 8th Floor
St. Louis, MO 63108

If appropriate, a financial specialist is available to answer questions about health insurance and identify resources for expenses related to cancer care.

Our referral specialists also handle requests for hospital-to-hospital transfers during regular business hours. Referring physicians will be quickly connected to a specialist physician on staff at Barnes-Jewish Hospital who can authorize a transfer. After-hours requests can be made by calling the hospital’s Doctors’ Access Line at 314-747-3251 or 800-252-3627.