Cell Therapy Program
Hoag Family Cancer Institute is proud to expand its advanced treatment offerings with Cellular Therapy treatments, reinforcing its commitment to exceptional, leading-edge cancer care. Hoag is one of the first in Orange County to offer this innovative, FDA-approved therapy for malignant blood and lymphatic cancers, and the first to provide cell therapy for solid tumors through its robust clinical research program.
Cellular therapy offers a multitude of different types of treatment options that Hoag is committed to adopting into the new standard of practice to help fight different types of cancer, even when other treatments are no longer effective.
Cellular Therapy is personalized immunotherapy that treats cancer by modifying a patient's own immune cells to recognize and destroy cancer cells.
Types of Cellular Therapy Treatment offered at Hoag:
Chimeric Antigen Receptor T- (CAR-T) Cell Therapy for lymphoma and myeloma
CAR-T therapy is a type of immunotherapy that uses a person’s own immune cells, called T cells, and makes them stronger so they can identify and attack cancer cells. First, T cells are removed from a patient’s blood. Next, the cells are modified in a laboratory, adding the gene for a molecule receptor called a chimeric antigen receptor (CAR). Millions of these CAR-T cells are grown in the laboratory, and then given back to the patient through an infusion. These new cells can seek out cancer cells, attach to them and destroy them. We offer standard of care second line treatment with CAR-T cell products such as Cilta-cel and Axi-cel for patients with myeloma and lymphoma.
A New Chapter for CAR-T Therapy in Solid Tumors
For the first time, the FDA has approved a CAR-T therapy for a solid tumor. Afami-cel is now approved for certain patients with synovial sarcoma, and a second therapy, lete-cel, is currently under FDA review.
Progress is also being made in gastric (stomach) cancer. A CAR-T therapy designed to target a protein called Claudin 18.2 has been submitted to the FDA for approval as a second-line treatment. In a large clinical study, this therapy helped patients with advanced gastric cancer live longer and respond better than those who received standard chemotherapy.
Cell Therapy Research Trials
Researchers are continuing to improve CAR-T therapies to make them more effective and longer-lasting in solid tumors. Newer “armored” CAR-T cells are being developed to help the treatment work more powerfully inside the tumor environment.
At Hoag, we are actively advancing CAR-T research as part of our cancer program. We offer multiple research trials using cellular therapy. These trials include CAR-T cell therapy, modified T-Cell receptor therapy and natural killer cell therapy. These trials treat many solid and liquid cancer diagnoses including lymphoma, myeloma, lung, liver, Merkel cell, and target specific mutations.
Contact Us: 949-722-6237
Hoag is proud to offer access to board-certified specialists who are at the forefront of delivering CAR-T therapy. They are available and currently accepting new patients.
Raghuveer Ranganathan, MD, Program Director, Immune Effector and Cellular Therapy
Pooja Motwani, MD, Medical Director, Benign and Malignant Hematology
Benjamin H. Goldenson, MD, Benign and Malignant Hematology
Eduardo Fernandez Hernandez, MD, Benign and Malignant Hematology
Carlos R. Becerra, MD, Medical Director, Cancer Research
FAQ
You will go to the Hemapheresis and Transfusion Support (HATs) Department to have your cells collected.
You will need to stop eating and drinking after midnight the day before your catheter is placed.
The CAR-T cell collection is called apheresis. Your blood will be removed through the catheter and filtered through a machine that will collect your T cells in a bag. The remaining blood is returned to you through the catheter.
You will have an intravenous (IV) catheter put in your chest prior to the collection.
You will be watched very closely by a specialized apheresis nurse who is trained to use the machine and care for you during collection.
The collection will take about four hours. When it is finished, we will remove the catheter.
The cells will be shipped to a lab to be genetically modified and prepared for infusion. Then, the cells are frozen and shipped back to your Hoag provider. This process takes about two to four weeks.
You may get chemotherapy during this time period if your doctor thinks it is needed.
You will then be given chemotherapy two to three days prior to the infusion to help prepare your body to receive the CAR-T cells.
The infusion of CAR-T cells will be done in the in-patient hospital.
Once the cells are ready for infusion, we will put in a peripherally inserted central catheter (PICC), which is a special IV in your arm.
The cells will be given through your peripherally inserted central catheter (PICC) line. You will be monitored during and after the infusion by your team, and your vital signs will be taken frequently.
We will continue to watch you closely for potential side effects of CAR-T cell therapy, such as cytokine release syndrome or other neurological toxicities.
Post-discharge, we will continue to watch you closely for potential side effects of CAR-T cell therapy, such as cytokine release syndrome or other neurological toxicities.
You should not drive, operate heavy machinery, or do other potentially dangerous activities for four to eight weeks after the infusion. Your provider will tell you how long you need to wait.
CAR-T cells may cause confusion and memory problems, difficulties speaking, hallucinations or seizures. These symptoms most often occur within the first eight weeks after infusion and usually are temporary . Your treatment team is prepared to identify and treat these symptoms if needed.
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