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
Health Lab
Fitness instructor, backpacker returns to active lifestyle after years of pain from endometriosis
Woman seeks answers for painful periods, leading to the discovery of endometriosis, large ovarian cysts, organ inflammation and appendix cancer
Woman in pink shirt lifts kettleball in an outdoor exercise class
Health Lab
How to make cancer prevention more equitable
Expert explains six behavioral risk factors for cancer and why current programs don’t always meet the needs of people from racially and ethnically minoritized groups and other vulnerable populations.
Don Reynolds, seated at right, and his family gather together. Reynolds can garden with his grandchildren after a successful treatment with Pluvicto. Photos courtesy of the Reynolds family
Health Lab
Pluvicto treatment gives patient another chance
New treatment for metastatic castration resistant prostate cancer helped patient get back to his hobbies
Portrait of Max Wicha, founding director of Rogel Cancer Center
Health Lab
‘We might for the first time really be thinking of cures of cancer’
Founding Rogel Cancer Center Director reflects on how cancer evolved from ‘the least scientific discipline’ to a shining example of how basic research discoveries can change clinical care.
Gloved hands holding silicone chips used in cancer research
Health Lab
Is lung cancer treatment working? This chip can tell from a blood draw
Using a chip to process blood samples, doctors can monitor the amount of cancer cells in a patient’s blood to determine how well a treatment is working by the fourth week, according to a new study.
art work with flower circle green teal orange yellow pink on display
Health Lab
Quiet strength of nature heals those dealing with cancer
An art exhibition explores the physical and emotional complexities of the cancer journey by combining anatomy with nature.