CAR-T on a Mission

Photo by Leisa Thompson Photography

One of the many exciting things about working at an academic medical center is the constant exposure to the research discoveries and technologies that ultimately become translatable to patient care applications. The great advances in technology and science have fueled so much progress that we now have broad opportunities — in areas like precision health, 3D printing, and artificial intelligence — that demand constant attention and continuing medical education. 

A promising new type of immunotherapy has now emerged: the development of chimeric antigen receptor T cells (CAR-T) to treat the most common form of acute leukemia in children and young adults, and a common form of lymphoma in adults. CAR-T therapy relies on genetically modifying our immune surveillance cells (called T cells) to target proteins on the surface of a patient's own cancer. Once infused, the CAR-T cells begin an immediate search-and-destroy mission, targeting those cancer cells. 

In practice, CAR-T therapy requires isolating T cells from an aliquot of a patient's blood, growing the T cells outside the patient's body, inserting a specific anti-cancer (CAR) gene into the T cells, and then administering the cells to the patient by intravenous infusion. The process to "manufacture" the CAR-T cells routinely takes three to four weeks. What's amazing is that we are using a patient's own T cells to create this anti-tumor product. 

Until recently, CAR-T therapy was limited to multicenter clinical trials, to treat patients with relapsed or refractory hematologic malignancies. In 2017, the FDA approved two CAR-T therapy approaches, one to treat acute lymphoblastic leukemia (ALL) in children and another to treat adults with diffuse large cell lymphoma. The fact that its application was FDA-approved in children before adults, an anomaly in cancer therapeutics, makes this treatment even more exciting. 

At Michigan Medicine, our pediatric and adult hematology/oncology teams — led by Greg Yanik, Challice Bonifant, and Rajen Mody in pediatrics; and Pavan Reddy, John Magenau, and Monalisa Ghosh for adult patients — have been at the forefront of administering this new treatment to patients. Michigan Medicine has now treated 12 patients with CAR-T therapy for ALL, and we remain the only medical center in the state approved to use CAR-T cells for the treatment of refractory ALL. 

With the convergence of technology, engineering, and health care, CAR-T is one of many examples of emerging therapies that give new hope for treating very difficult or otherwise fatal diseases. Likewise, promising and growing data suggest that CAR-T cells could treat adult patients who have a wide variety of blood cancers, including multiple myeloma and several types of lymphomas. At U-M — thanks to our research and academic endeavors, as well as resources across campus — we are uniquely positioned to use and learn from such innovative therapies, and we anticipate helping many more children and young adults in the years ahead. 

David A. Spahlinger, M.D. 
Executive Vice Dean for Clinical Affairs 
President, U-M Health System
Clinical Professor of Internal Medicine 


More Articles About: CAR-T chimeric antigen receptor immunotherapy Cancer (Oncology)
Featured News & Stories woman outside by water and woman with care team infusion
Health Lab
Immunotherapy saves woman with stage 4 colon cancer
A Michigan Medicine expert describes immunotherapy as “the future of cancer treatment” for those who qualify.
cancer cell
Health Lab
Language barriers in cancer care
Research from experts at Michigan Medicine shows that significant language-based disparities exist in patients’ access to cancer care services, and it’s well before their first appointment with a doctor. 
man at table writing down in living room
Health Lab
Free online tool helps prostate cancer patients save on out-of-pocket drug costs
A free online tool could potentially save some prostate cancer patients more than $9,000 in out-of-pocket drug costs, a Michigan Medicine study finds.
Rogel Cancer Center illustration
News Release
Rogel Cancer Center awarded $37M from NCI
The National Cancer Institute has awarded the U-M Rogel Cancer Center a grant worth $37 million over five years and renewed the center’s designation as a “comprehensive cancer center.”
cancer cell yellow blue
Health Lab
Research sheds light on low rates of genetic testing for cancer
Research finds genetic testing for cancer can bring more knowledge to patients and their relatives, but not many people get it done.
brain drawing
Health Lab
Life stressors may contribute to multiple sclerosis flares, disability
Life stressors can contribute to multiple sclerosis flares and disability. Learn about the research on how stress can impact MS, and how to manage stress to improve your health.