Not long ago, the diagnosis of 'leukemia' sounded like a death sentence, causing feelings of panic and hopelessness in patients. The negative prognosis was based on the fact that surgical treatment and radiotherapy, which are part of the gold standard for treating other types of cancer, are ineffective in the case of blood cancer. However, today patients with this condition have hope for recovery, as their own bodies are successfully fighting malignant cells. This refers to a progressive immunotherapeutic method — adaptive CAR-T cell therapy. CAR-T therapy in Israel helps two-thirds of patients under fifty years of age cope with blood cancers, while among young children, the rate of long-term durable remission exceeds 90%, and among adolescents — 80-85%.
CAR-T therapy is based on equipping the patient's T-lymphocytes with the ability to recognize and actively destroy malignant B-lymphocytes, which are the cause of leukemia. The procedure is performed by qualified oncologists who have trained at leading medical centers and laboratories in the USA, where CAR-T therapy has been conducted for several years. For medical tourists, many of whom have long been unsuccessfully battling leukemia or lymphoma and have encountered the ineffectiveness of all applied treatment methods, the cost of CAR-T therapy in Israel is an attractive factor. Although this method is among the expensive ones, treatment in Israeli clinics is much cheaper for patients than in the USA and Western Europe.
When is CAR-T therapy performed
Numerous clinical trials have demonstrated the effectiveness of CAR-T therapy in the case of the following types of blood oncopathologies:
- relapsed B-cell acute lymphoblastic leukemia in patients under 25 years of age;
- diffuse large B-cell lymphoma in patients under fifty years of age with relapse occurring after two lines of therapy or in cases of initial resistance to the treatment provided.
In more than 50% of patients undergoing CAR-T therapy, significant reversible side effects may develop. In most cases, patients experience what is known as a cytokine storm, manifested by chills, fever, a sharp drop in blood pressure, and back pain. Additionally, neurological disorders may develop: headaches, tremors, and seizures. To alleviate painful symptoms and avoid the development of a severe condition, the patient should remain in the clinic under medical supervision for 2-3 weeks.
Due to the high likelihood of side effects, CAR-T therapy is not performed on elderly patients suffering from chronic somatic diseases. It is also recommended to undergo at least two courses of chemotherapy before starting CAR-T therapy.
CAR-T therapy shows the greatest effectiveness in pediatric patients, achieving long-term durable remission in approximately 90% of cases. In adolescents, this figure is 80-83%, while among patients under 50 years of age, it is about 70%. Convincing evidence of the success of CAR-T therapy in Israel is the feedback from treated patients and their relatives.
What is CAR-T therapy and how is it performed
CAR-T therapy (Chimeric Antigen Therapy), one of the methods of adaptive cell therapy, is based on the artificial production of T-lymphocytes' ability to recognize leukemia cells. T-cells are extracted from the patient's blood, after which they are modified in laboratory conditions using microbiological techniques and become capable of expressing a chimeric antigen receptor (CAR) on their surface. The receptor is called chimeric because it consists of two peptide molecules — an antibody and a T-lymphocyte receptor. CAR recognizes the CD19 marker on the surface of B-lymphocytes responsible for the development of blood cancers. Thus, T-lymphocytes gain the ability to overcome the masking of malignant blood cells, recognize them, and destroy them.
Procedure for CAR-T therapy
- Blood collection from the patient and isolation of T-lymphocytes.
- Genetic modification of T-cells in a certified laboratory and cultivation for 2-3 weeks.
- During the time required to prepare the modified T-lymphocytes, the patient undergoes chemotherapy to suppress the activity of the immune system, which is necessary for the effective absorption of CAR-T cells in the patient's body.
- The patient is intravenously administered a culture of modified T-lymphocytes at a volume of 1 million cells per kilogram of body weight. Subsequently, the introduced T-cells multiply, and their number reaches the level necessary for successful therapy.
- After the procedure, the patient remains in the clinic for 2-3 weeks for monitoring their condition.
Two months after the effective CAR-T therapy, bone marrow transplantation is recommended.
CAR-T therapy in Israel: prices
The high cost of CAR-T therapy is due to the expensive laboratory process of modifying and cultivating T-lymphocytes. At the same time, the equipping of Israeli clinics with modern equipment and the high level of specialists' qualifications make treatment in Israel 30-50% cheaper than in Western European and American medical centers.
- Burkitt-like lymphoma
- T-cell precursor lymphoma
- Reticulosarcoma
- Centroblast B-cell lymphoma
Advantages of CAR-T therapy in Israel
- High level of qualification and extensive experience accumulated by doctors.
- Professional mastery of progressive methods for treating blood cancers.
- Equipping oncology departments with modern equipment.
- Effective management of possible side effects.
- The cost of CAR-T therapy is lower than in American clinics, with the same quality of procedure.