Treatment Options

CAR-T Cell Therapy

Precisely attacking cancer cells with the patient's own immune cells

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Illustration: purple T cells surrounding a red cancer cell (AI-generated)

What Is CAR-T Cell Therapy?

CAR-T cell therapy stands for chimeric antigen receptor (CAR)-T cell therapy. It is a cancer treatment that takes cells from the body and genetically changes them so they can fight cancer. It falls under the category of immunotherapy, which harnesses the body's immune system to attack cancer cells, and it's most often used to treat cancers that affect blood cells, such as certain types of leukemia, lymphoma and multiple myeloma.

Making CAR-T cells starts with collecting a person's own T cells. T cells are collected from the blood using a process called apheresis. In the lab, these T cells are modified to produce synthetic proteins called chimeric antigen receptors (CARs). The modified cells are called CAR-T cells. They are grown to much higher numbers in the lab and then infused back into the person's bloodstream.

The synthetic CARs allow the T cells to bind to specific proteins called antigens on cancer cells. This binding activates the T cells to kill the cancer cells. Dying cancer cells trigger further immune responses against the cancer. In addition, CAR-T cells can keep multiplying in the body, producing lasting anticancer results.

Illustration: T cells (purple) surrounding a cancer cell (red). AI-generated.

T cellT lymphocyte
A type of white blood cell that can identify and attack cells that don't belong in the body, such as germs and cancer cells — a key player in the immune system.
Chimeric antigen receptorCAR
A synthetic protein made on the surface of T cells in the lab; it recognises specific antigens on the surface of cancer cells.
ApheresisLeukapheresis
A machine separates the different parts of the blood and keeps the T cells; the rest goes back into your body.

Who It May Help

CAR-T cell therapy is used to treat cancers that affect blood cells. This includes some types of leukemia, lymphoma and multiple myeloma.

CAR-T cell therapy may not be for every person diagnosed with one of these cancers. Discuss the treatment risks and benefits with your cancer team.

CAR-T cell therapy is evolving for many different types of cancers, sometimes in clinical trials. Ask your team if a clinical trial may be right for you.

CAR-T cell therapy may be recommended when a cancer is:

Refractory

Doesn't respond to other treatments.

Relapsed / Recurrent

Comes back within 12 months after the first treatment, or after several prior treatments.

CAR-T cell therapy is approved to treat recurrences of the following cancers:
  1. 01

    B-cell acute lymphoblastic leukemia

    This type of blood cancer is the most common cancer found in children.

  2. 02

    Chronic lymphocytic leukemia

    This leukemia progresses more slowly than other leukemias. It occurs most often in older adults.

  3. 03

    Certain B-cell non-Hodgkin lymphomas

    Lymphomas are cancers that affect white blood cells in the lymphatic system — a network of organs, glands, vessels and clusters of cells called lymph nodes. B-cell lymphomas for which CAR-T cell therapy may be an option include:

    Diffuse large B-cell lymphomaPrimary mediastinal large B-cell lymphomaHigh-grade B-cell lymphomaAggressive B-cell lymphoma, not otherwise specifiedFollicular lymphomaMantle cell lymphoma
  4. 04

    Multiple myeloma

    This uncommon form of blood cancer affects bone marrow. The cancer forms in a type of white blood cell called a plasma cell.

How Does CAR-T Cell Therapy Work?

T cells are taken from the blood, given a receptor in the lab that recognises cancer cells, multiplied, and returned to the body.

  1. 01

    Collection Apheresis

    T cells are collected from the blood. This process is called apheresis.

  2. 02

    Engineering

    In the laboratory, scientists add a gene to the T cells that makes them produce chimeric antigen receptors (CARs) on their surface. The CARs can recognise and target a specific protein on the surface of the cancer cells.

  3. 03

    Expansion

    These changed T cells grow and multiply in the laboratory until there are enough CAR-T cells.

  4. 04

    Infusion

    You have a drip containing the cells back into your bloodstream, where they recognise and attack the cancer cells. They can stay in your body for long periods of time, recognising and attacking the specific cancer cells.

NMPA-Approved CAR-T Products in China

In China, the National Medical Products Administration (NMPA) has also approved several CAR-T cell products to treat hematologic malignancies.

Examples marketed outside China

There are different types of CAR-T cell therapy made by different companies, these include:

  • tisagenlecleucelKymriah
  • axicabtagene ciloleucelYescarta
  • brexucabtagene autoleucelTecartus
NMPA-approved · 7 products
Generic NameBrand NameTarget
Axicabtagene ciloleucelYikaida®奕凯达CD19
Relmacabtagene autoleucelBeinuoda®倍诺达CD19
Equecabtagene autoleucelFukesu®福可苏BCMA
Inaticabtagene autoleucelYuanruida®源瑞达CD19
Zevorcabtagene autoleucelSaikaize®赛恺泽BCMA
Ciltacabtagene autoleucelKaweidi®卡卫荻BCMA
Leniolyscabtagene autoleucelHengkailai®恒凯莱CD19
  • Yikaida®奕凯达Axicabtagene ciloleucel
    CD19
  • Beinuoda®倍诺达Relmacabtagene autoleucel
    CD19
  • Fukesu®福可苏Equecabtagene autoleucel
    BCMA
  • Yuanruida®源瑞达Inaticabtagene autoleucel
    CD19
  • Saikaize®赛恺泽Zevorcabtagene autoleucel
    BCMA
  • Kaweidi®卡卫荻Ciltacabtagene autoleucel
    BCMA
  • Hengkailai®恒凯莱Leniolyscabtagene autoleucel
    CD19

Target: the antigen on the cancer cell surface that the CAR recognises.

Having CAR-T Cell Therapy

From collecting your T cells to monitoring after the infusion, treatment roughly follows six stages. Each hospital's arrangements differ slightly, so follow the advice of the hospital you are under.

Key timings
4–6 hours
To collect your T cells
Several weeks
To make the CAR-T cells in the lab
< 30 min
The infusion usually takes less than 30 minutes
2 weeks
Close monitoring after the infusion
30 days
Stay within one hour of the hospital after treatment

  1. Preparing for T cell collection

    Before you have T cell collection your doctor might ask you to stop treatments such as steroids and chemotherapy. This helps increase the number of T cells in your blood before they are collected, and helps them to be in good form. You have several tests to make sure you are well enough to have your T cells removed.

  2. Collecting your T cells

    Collection takes 4–6 hoursManufacturing takes several weeks

    First you have a tube (cannula) put into a vein in each arm. You might need a special tube called a vascath or a PICC line if the veins in your arms aren't big enough. One tube removes the blood and passes it into an apheresis machine, which takes out your T cells. The rest of your blood cells and blood fluid go back into your body through the tube in your other arm.

    The specialist nurse sends your T cells to the laboratory to make CAR-T cells. This can take several weeks. When they have enough CAR-T cells, they freeze them.

  3. Bridging treatment

    While your CAR-T cells are being made some people might need treatment such as chemotherapy or radiotherapy. This is to help keep the cancer under control until the CAR-T cells are ready.

  4. Lymphodepletion

    Starts about a week before

    You have chemotherapy over a few days, starting about a week before the day you have the CAR-T cells. This lowers the number of T cells in your blood and prepares your body for the CAR-T cells. You might also hear it called conditioning treatment.

  5. Having the CAR-T cells

    Usually under 30 minutes

    A specially trained nurse defrosts the CAR-T cells on the ward and gives you medicines into your vein to stop allergic reactions. You then have the cells as a drip into your bloodstream. You are closely monitored during and after the treatment.

  6. Staying in hospital & follow-up

    Close monitoring for 2 weeksStay nearby for up to 30 days
    First 2 weeks
    The doctors and nurses need to monitor you closely.
    Well after 2 weeks
    You may be able to go home if you live within one hour of the hospital, or stay in a hotel or other residence nearby. One of the requirements is that you have someone with you 24 hours a day; if you don't, you must stay in hospital for the first month after the treatment.
    After discharge
    You are still closely monitored. This involves visiting the day care unit several times a week. On the days you don't visit, you get a phone call to check how you are doing, and you will have the numbers of people to contact if you get any problems.
    Not well after 2 weeks
    You stay in hospital until your healthcare team think it is safe for you.
    Up to 30 days
    Stay within one hour of the hospital for up to 30 days after the treatment. Each CAR-T hospital has slightly different advice, so follow the advice of the hospital you are under.

Some content is adapted from the official website of Cancer Research UK.The hero illustration is AI-generated and does not depict real microscopy.

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