CAR T-Cell therapy in Israel

CAR T- Cell therapy in Israel is growing at a very rapid pace. Sheba and Ichilov hospitals in Tel Aviv, Israel have already started CAR T-cell therapy. Sheba hospital is making their own CAR T-cells and thus restricts themselves to treatment of some type of leukemia, lymphoma and myeloma. On the other hand Ichilov hospital is using CAR T-cells of Novrtis and thus has more types of cancer to treat.

Israel’s extensive explorations and breakthroughs in the search of novel target antigens, optimization of CAR structure, cocktail CAR-T therapy, combination therapy, and extension of CAR-T cell applications, imply that we are currently on the verge of a revolution in CAR-T therapy. US FDA has approved CAR T Cell therapy for relapsed B Acute lymphoblastic leukemia, lymphoma & multiple myeloma.

What is CAR T-Cell therapy (Chimeric antigen receptors)?

CAR T-Cell therapy is a form of immunotherapy that uses specially modified T-cells which are part of our immune system to fight cancer. A sample of patients T cells are collected from the blood, then it is modified to produce special structures called chimeric antigen receptors (CAR) on their surface. When these modified CAR cells are re infused in the patient, these new cells attack the specific antigen and kills the tumor cells.

How does CAR T-Cell therapy work?

CAR T-cell therapy takes help from body’s own immune system to attack and kill cancer cells. This is done by removing some specified cells from the blood of the patient, modifying them in the lab and re-injecting them into the patient. CAR T-cell therapy has produced very encouraging results in Non-Hodgkin lymphoma and thus approved by FDA.

Who are the right candidates for CAR T-Cell therapy ?

At present FDA has approved CAR T-Cell therapy for some forms of aggressive and refractory Non-Hodgkin lymphoma and relapsed and refractory acute lymphoblastic leukemia. Patient need to send full medical reports to ascertain the use of CAR T-Cell therapy for his treatment.

Inclusion criteria for CAR T-cell therapy :

1. Patients with CD19+ B-cell Lymphoma(At least 2 prior combination chemotherapy regimens)

2. To be aged 3 to 75 years

3. ECOG score ≤2

4. Women of childbearing potential must have a urine pregnancy test taken and proven negative prior to the treatment. All patients agree to use reliable methods of contraception during the trial period and until follow-up for the last time.

Exclusion criteria for CAR T-cell therapy :

1. Intracranial hypertension or unconsciousness

2. Respiratory failure

3. Disseminated intravascular coagulation

4. Hematosepsis or Uncontrolled active infection

5. Uncontrolled diabetes

Advantages of CAR T-Cell therapy

1. >5000 CAR T cases done by highly skilled doctor’s.
2. Hospitals in China has developed more CAR T Cell types including CD19 & CD 22 then any other country in the world.
3. China is conducting more than 300 clinical trials on CAR T Cell therapy. More than any other country on the planet.
4. Clinical effect of CAR T Cell is similar to that in USA or any other country and sometimes better.

Treatment process for CAR T-Cell therapy

• Complete evaluation of the patient
• T-cell collection from the body
• T-cells are then engineered in the lab
• Genetically engineered T-Cells are then multiplied by using growing them in the laboratory. These cells are frozen and then sent to the treating centres.
• Prior to infusing, patient may be given chemotherapy for their cancer. This helps the therapy work in a better way.
• Soon after chemotherapy CAR T-Cells are infused by a process which is similar to blood infusion.
• There is a 2-3 month of recovery period for the patient.

Time frame for CAR T-Cell therapy

1. Examination & test: one week

2. Pre-treatment & T-Cell Collection: one week

3. T-Cell preparation & return: two-three weeks

4. 1st Effectiveness analysis: three weeks

5. 2nd Effectiveness analysis: three weeks

Side effects of CAR T-Cell therapy

The common side effects of CAR T-cell therapy include:

• Cytokine release syndrome
  In some cases, patients may develop flu-like symptoms such as fever, chills, headache, nausea, vomiting, loose stools, and muscle or joint pains. It may also cause low blood pressure, difficulty in breathing, and a fast heart rate. These side effects are due to the release of cytokines by the immune cells during CAR T-cell therapy. These symptoms are usually mild, but can be serious and life threatening in some patients.
• Neurological events
  Neurological events can occur and can be serious in some patients. Such events include encephalopathy (brain injury and malfunction), confusion, difficulty speaking, agitation, seizures, drowsiness, altered state of consciousness and loss of balance.
• Neutropaenia and Anaemia
  Some patients may develop neutropenia or low white cell count.  Similarly, anaemia or low red blood cell count may also occur due to this therapy.
  .
  Fortunately, most of these side effects usually resolve on their own or can be managed with the use of  medications.

How effective is CAR T-Cell therapy ?

CAR T-cell therapy for the treatment of lymphoma and other blood cancers has shown promising outcomes. Since CAR T-cell treatment, many patients who had previously relapsed blood tumours had promising results and no evidence of cancer. It has also aided in the rehabilitation of patients who have previously failed to respond to most traditional cancer therapies.

However, longer-term studies for a larger patient population are needed to validate the efficacy of this treatment. Large-scale experiments would also aid in determining the likelihood of side effects and the right ways to deal with them.

How much does CAR T-Cell therapy cost ?

Israel is among the world leader in CAR-T cell therapy & BMT.  Cost of CAR T-cell therapy in Sheba hospital, Israel comes out to be around $150,000 USD and in Ichilov hospital is around $ 510,000 USD.

Also read this : CAR T Cell therapy in India 

How can I take CAR T-Cell therapy in Israel?

Patient can call +91 96 1588 1588 or email to cancerfax@gmail.com with patient details and medical reports and we shall arrange for second opinion, treatment plan, estimate of expenses, medical visa, local guest house and all kind of local help.