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On September 15, Professor Ying Zhitao from Peking University Cancer Hospital brought us a live lecture on CAR-T treatment
.
Professor Ying Zhitao, Peking University Cancer Hospital, Doctor of Medicine, Deputy Chief Physician, Youth Committee, Hematology and Oncology Committee, Chinese Anti-Cancer Association Committee, Chinese Geriatric Hematology and Lymphoma Group, Youth Committee, Chinese Medical Association Oncology Branch, Chinese Society of Clinical Oncology (CSCO) Youth Expert Committee Member of the Committee on Clinical Research and Evaluation of Drugs of the Chinese Geriatric Healthcare Association.
The main research direction is the standardized diagnosis and treatment of lymphoma.
Participated in the compilation of multiple oncology books and published more than 20 papers in the live broadcast.
Professor Ying Zhitao on CAR-T treatment The process, common side effects and common problems in treatment are explained in detail
.
In order to help friends who missed the live broadcast to understand CAR-T cell therapy, the editor summarizes the knowledge content shared by Professor Ying Zhitao for your reference
.
What is CAR-T? How does it work? To understand CAR-T, you must first know T cells
.
T cells are the "health guards" in the human body.
They play a monitoring role when abnormalities such as tumors and infections occur in the human body, identify tumor cells and foreign viruses, and kill foreign substances
.
Tumor patients often have problems such as the decrease in the number and quality of T cells, and the tumor cells themselves can escape the surveillance role of T cells, which results in the tumor cells being unable to be effectively identified and killed, and tumor progression and metastasis occur
.
By collecting normal T cells from the body, performing gene editing and transformation in vitro, and loading the T cells with chimeric antigen receptors, the resulting cells are CAR-T cells, also known as chimeric antigen receptor T cells
.
Compared with T cells, CAR-T cells are more like "super fighters", their ability to kill tumor cells has been greatly improved, and they can proliferate in large quantities both in vivo and in vitro
.
When CAR-T cells are returned to the patient's body, under the "navigation effect" of the chimeric antigen receptor, tumor cells can be found more accurately and killed
.
What is the process of CAR-T treatment? Before CAR-T treatment, routine inspection and evaluation are required to determine whether the treatment conditions are met
.
After the evaluation is completed, T cell collection is performed on the patient, and the transformation and proliferation of T cells are carried out in vitro.
This process generally takes 3 to 4 weeks
.
After the CAR-T cell culture is completed, the patient needs to undergo lymphocyte depletion chemotherapy, that is, to remove the original lymphocytes in the body to make room for the proliferation of CAR-T cells, and then the CAR-T cells can be infused
.
Generally speaking, patients need to observe in the hospital for 1 to 2 weeks after reinfusion of CAR-T cells in order to deal with the possible toxic side effects in time
.
How effective is CAR-T treatment? Taking the treatment of patients with relapsed and refractory diffuse large B-cell lymphoma as an example, compared with only receiving traditional treatment (chemotherapy, targeted therapy, immunotherapy, etc.
), the effective rate of CAR-T treatment has been greatly improved
.
It needs to be emphasized that CAR-T is not a magic drug.
In the long-term follow-up of 4 to 5 years, it is found that although 30% to 40% of patients can benefit from CAR-T treatment for a long time, there are still some patients.
Relapse progression may occur
.
What are the side effects of CAR-T treatment? After CAR-T cells are imported into the body, they are expanded in a large amount in the body to kill tumor cells
.
During this process, a large number of cytokines are produced.
These cytokines will act on various tissues and organs of the body, causing toxic side effects
.
The most important side effects are cytokine release syndrome and neurotoxicity
.
Cytokine release syndrome mainly manifests as fever, decreased blood pressure, and hypoxemia
.
Neurotoxicity is manifested as a variety of neurological symptoms, such as headaches, slurred speech, unsteady walking, and severe seizures, cerebral edema, coma and other symptoms
.
Of course, with the accumulation of CAR-T treatment experience, these toxic side effects can often be handled appropriately, usually without sequelae
.
What is the cost of CAR-T cell therapy? Why is it so expensive? Will the price be reduced? Due to the complexity of CAR-T treatment links, individualized methods, and huge R&D and production costs, the treatment costs are also very high, about 3 million yuan per needle abroad
.
And thanks to some domestic efforts, the price of CAR-T treatment in China is about 1.
2 to 1.
3 million yuan per needle.
Of course, this is only the price of CAR-T cells, and the actual cost of hospitalization is more than that
.
The current CAR-T cells are all self-derived and can only be "privately customized".
In the future, mass production of CAR-T cells from allogeneic sources is expected, which will greatly reduce their prices
.
Although CAR-T cells from allogeneic sources still have shortcomings such as short survival time, slow proliferation, and possible rejection reactions, with the advancement of technology, CAR-T therapy from allogeneic sources is still worth looking forward to
.
In addition to sharing knowledge of CAR-T therapy, Professor Ying Zhitao also reminded that CAR-T therapy requires the collection of high-quality cells as raw materials, and a good body to bear the treatment response.
At the same time, the faster the tumor progresses, the higher the burden and the curative effect.
It will be worse
.
Therefore, it is recommended that patients who meet the conditions of CAR-T treatment should be treated as soon as possible
.
The above is all the essence of the live broadcast of Professor Ying Zhitao.
I hope this article can help you
.
Poke "read the original text", we make progress together
.
Professor Ying Zhitao, Peking University Cancer Hospital, Doctor of Medicine, Deputy Chief Physician, Youth Committee, Hematology and Oncology Committee, Chinese Anti-Cancer Association Committee, Chinese Geriatric Hematology and Lymphoma Group, Youth Committee, Chinese Medical Association Oncology Branch, Chinese Society of Clinical Oncology (CSCO) Youth Expert Committee Member of the Committee on Clinical Research and Evaluation of Drugs of the Chinese Geriatric Healthcare Association.
The main research direction is the standardized diagnosis and treatment of lymphoma.
Participated in the compilation of multiple oncology books and published more than 20 papers in the live broadcast.
Professor Ying Zhitao on CAR-T treatment The process, common side effects and common problems in treatment are explained in detail
.
In order to help friends who missed the live broadcast to understand CAR-T cell therapy, the editor summarizes the knowledge content shared by Professor Ying Zhitao for your reference
.
What is CAR-T? How does it work? To understand CAR-T, you must first know T cells
.
T cells are the "health guards" in the human body.
They play a monitoring role when abnormalities such as tumors and infections occur in the human body, identify tumor cells and foreign viruses, and kill foreign substances
.
Tumor patients often have problems such as the decrease in the number and quality of T cells, and the tumor cells themselves can escape the surveillance role of T cells, which results in the tumor cells being unable to be effectively identified and killed, and tumor progression and metastasis occur
.
By collecting normal T cells from the body, performing gene editing and transformation in vitro, and loading the T cells with chimeric antigen receptors, the resulting cells are CAR-T cells, also known as chimeric antigen receptor T cells
.
Compared with T cells, CAR-T cells are more like "super fighters", their ability to kill tumor cells has been greatly improved, and they can proliferate in large quantities both in vivo and in vitro
.
When CAR-T cells are returned to the patient's body, under the "navigation effect" of the chimeric antigen receptor, tumor cells can be found more accurately and killed
.
What is the process of CAR-T treatment? Before CAR-T treatment, routine inspection and evaluation are required to determine whether the treatment conditions are met
.
After the evaluation is completed, T cell collection is performed on the patient, and the transformation and proliferation of T cells are carried out in vitro.
This process generally takes 3 to 4 weeks
.
After the CAR-T cell culture is completed, the patient needs to undergo lymphocyte depletion chemotherapy, that is, to remove the original lymphocytes in the body to make room for the proliferation of CAR-T cells, and then the CAR-T cells can be infused
.
Generally speaking, patients need to observe in the hospital for 1 to 2 weeks after reinfusion of CAR-T cells in order to deal with the possible toxic side effects in time
.
How effective is CAR-T treatment? Taking the treatment of patients with relapsed and refractory diffuse large B-cell lymphoma as an example, compared with only receiving traditional treatment (chemotherapy, targeted therapy, immunotherapy, etc.
), the effective rate of CAR-T treatment has been greatly improved
.
It needs to be emphasized that CAR-T is not a magic drug.
In the long-term follow-up of 4 to 5 years, it is found that although 30% to 40% of patients can benefit from CAR-T treatment for a long time, there are still some patients.
Relapse progression may occur
.
What are the side effects of CAR-T treatment? After CAR-T cells are imported into the body, they are expanded in a large amount in the body to kill tumor cells
.
During this process, a large number of cytokines are produced.
These cytokines will act on various tissues and organs of the body, causing toxic side effects
.
The most important side effects are cytokine release syndrome and neurotoxicity
.
Cytokine release syndrome mainly manifests as fever, decreased blood pressure, and hypoxemia
.
Neurotoxicity is manifested as a variety of neurological symptoms, such as headaches, slurred speech, unsteady walking, and severe seizures, cerebral edema, coma and other symptoms
.
Of course, with the accumulation of CAR-T treatment experience, these toxic side effects can often be handled appropriately, usually without sequelae
.
What is the cost of CAR-T cell therapy? Why is it so expensive? Will the price be reduced? Due to the complexity of CAR-T treatment links, individualized methods, and huge R&D and production costs, the treatment costs are also very high, about 3 million yuan per needle abroad
.
And thanks to some domestic efforts, the price of CAR-T treatment in China is about 1.
2 to 1.
3 million yuan per needle.
Of course, this is only the price of CAR-T cells, and the actual cost of hospitalization is more than that
.
The current CAR-T cells are all self-derived and can only be "privately customized".
In the future, mass production of CAR-T cells from allogeneic sources is expected, which will greatly reduce their prices
.
Although CAR-T cells from allogeneic sources still have shortcomings such as short survival time, slow proliferation, and possible rejection reactions, with the advancement of technology, CAR-T therapy from allogeneic sources is still worth looking forward to
.
In addition to sharing knowledge of CAR-T therapy, Professor Ying Zhitao also reminded that CAR-T therapy requires the collection of high-quality cells as raw materials, and a good body to bear the treatment response.
At the same time, the faster the tumor progresses, the higher the burden and the curative effect.
It will be worse
.
Therefore, it is recommended that patients who meet the conditions of CAR-T treatment should be treated as soon as possible
.
The above is all the essence of the live broadcast of Professor Ying Zhitao.
I hope this article can help you
.
Poke "read the original text", we make progress together
