Ø CAR(ChimericAntigen Receptors) T-CELLS: Definition:CAR T-cells arethose T cells in which we insert the gene for Chimeric Antigen Receptor (CAR)and these receptors are then displayed on CAR T cells surfaces. Ø CHIMERIC TCELLS RECEPTORS: Definition:Chimeric TCells receptors are those recombinant Receptors that provide both antigenbinding and T-cells activating functions.Ø CAR T-cellsTHERAPY: Definition:A type oftreatment in which the gene for a specific receptors called CAR are inserted into T cells in order to modify theminvitro is called Chimeric Antigen Receptors T therapy. Ø CAR T-CELLSTHERAPY STEPS: 1. Blood from thevein in the patient’s arm is collected and flows through a tube to apheresismachine. 2. This machineremoves the White blood cells from the blood including T cells .
3. The rest ofblood excluding T cells is sent back to the patient.4.
Now the genefor special receptors called Chimeric antigen receptors (CAR) is inserted intoT cells in vitro.5. Millions of CARt cells are grown in the lab and given to patient by infusion.6. These CAR tcells can bind to antigen on cancer cells and kill them.Ø ADVERSE EFFECTSOF CAR T-CELLS THERAPY: 1.
Cytokine-releaseSyndrome (CRS): A serious side effect associatedwith Chimeric antigen receptors T-cells therapy is CRS. CRS is the result ofT-cell activation. CRS may result in high fever, headache, low blood pressure. 2. B-cellsAplasia: T-celltherapy targeting antigen (found on B-cells surface) not only destroyscancerous B cells but also normal B cells. Hence, B-cells absence results inlow production of antibodies. 3.
Tumor lysissyndrome: Itis a group of metabolic complications that can occur due to breakdown of dyingcells (cancerous cells). TLS can threat life. Ø BENEFITS/ADVANTAGES: CARs don’t require the antigen processing and presentation by HLA( Human leukocytes antigen) and are therefore applicable to HLA-diverse patient population. CARs provide a wider range of functional properties than transduced T-cell receptors (TCR), where strength of signaling, which is for the most part determined by the TCR’s attraction for antigen, is the principal cause of T-cell fate. This therapy utilizes body’s own immune system to fight cancer.
Ø ADVANCEMENT INCAR T-CELLS THERAPY: FDAApprovals:Recently, twodifferent CD19 CAR T-cell products got FDA approval. 1. Tisagenlecleucel(Kymirah) : The first CART-cell product to be approves and is used to treat B-cell acute lymphoblasticleukemia (B-ALL). 2.
Axicabtageneciloleucel (Yescarta) : After the few months of approval of Kymirah, another CAR T-cells product was approved that isused to treat adult refactory diffuselarge B-cell lymphoma . Ø FUTURE GOALS OFCAR T THERAPY: CAR T-celltherapy has got preliminary approval fortreatment of children and young adults with a specific form of leukemia that has not been cures withchemotherapy.