Treatment Category: Immunotherapy

WashU Medicine physicians and researchers at Siteman are pioneering a new form of cellular therapy known as natural killer cell (or NK cell) therapy. Only available in clinical trials at this time, natural killer cell therapy is a promising development in the ongoing effort to cure cancer.

About Natural Killer Cell Therapy

Natural killer cell therapy is a type of cellular immunotherapy, just like CAR T-cell therapy. Like T-cells, NK cells form part of the immune system and attack germs and other malignant cells. Unlike T-cells, however, NK cells are not tailored to specific antigens. Instead, they are a cellular Swiss Army knife that can detect and destroy any cell that looks abnormal.

While NK cells can recognize and attack cancer cells, they unfortunately don’t live long enough or multiply quickly enough to wipe them out entirely.  That’s where physicians and scientists come in. They enhance the NK cells by treating them with immune system proteins called cytokines. This helps them respond to cancer cells and improves their stamina and longevity. Sometimes, NK cells are also enhanced with chimeric antigen receptors (or CARS) to make them even more attuned to cancer cells.

In some ways, NK cell therapy is similar to CAR T-cell therapy. Both transform or enhance immune system cells so they can effectively fight cancer. One key difference between the two, however, is that the NK cells used in the treatment come from a donor, rather than the patient. m their diagnosis, through IV chemotherapy treatment, their surgery with HIPEC and follow up thereafter.

Advantages of Natural Killer Cell Therapy

There are many benefits to NK cell therapy.

• Compared to other forms of cancer treatment, such as chemotherapy, radiation, and even other immunotherapies, NK cell therapy does not cause many side effects. Patients tend to tolerate it well.
• NK cells don’t need to be genetically engineered to recognize cancer cells. This means that they are often faster to prepare. It only takes 24 hours to get them ready to infuse into the patient.
• NK cells are a treatment option for chemotherapy-resistant acute myeloid leukemia (AML).

Natural Killer Cell Therapy at Siteman

At this time, natural killer cell therapy is only accessible through clinical trials. Fortunately, WashU physicians at Siteman are some of the nation’s top experts in this emerging field.

Research conducted at our center helped demonstrate how NK cells could be adapted into a tool to fight cancer. A major Phase I clinical trial housed at the WashU Medicine, for instance, showed that treating NK cells with a cytokine called interleukin-12 helped them to destroy cancer cells in patients with acute myeloid leukemia, some of whom achieved complete remissions. This study became an important building block for the ongoing exploration and expansion of NK cell therapy.

If your oncologist believes NK cell therapy could be a good option for you, you will be enrolled in one of the clinical trials we offer onsite.

About CAR T-Cell Therapy 

CAR T-cell therapy is a new way to fight cancer. It is a kind of immunotherapy. Immunotherapies use your own immune system to attack cancer cells.   

Your body has special cells called T-cells. These cells normally fight germs and diseases. But in people with cancer, T-cells don’t recognize that cancer cells are dangerous.  

CAR T-cell therapy fixes this problem. It changes your T-cells so they can find and destroy cancer cells. Many patients who get this treatment stay cancer-free for a long time. This is called remission. Remission is different from a cure. Patients who are in remission are monitored carefully by their team of experts, so they continue to live high-quality, happy lives.   

Why Choose Siteman   

When you choose Siteman, you get care from experts who are leading the way in CAR T-cell therapy.  

Experience you can trust  

Siteman Cancer Center was one of the first hospitals in the country allowed to give CAR T-cell therapy. In 2017, we were one of only 16 hospitals the FDA chose to use the therapy. Our doctors and scientists helped turn the idea of CAR T-cell therapy into a real treatment. We led clinical trials that helped it become standard of care for patients today. Our doctors have spent years developing with this treatment and our teams have more experience than experts at almost any other hospital in the country. They know how to use it safely and help patients get the best results.  

Faster treatments  

CAR T-cell therapy uses your cells to create a treatment just for you. That takes time. At most hospitals, your cells are collected and then shipped to a facility for the CAR process. That can take several weeks from collection until your treatment begins.   

But at Siteman, we want patients to receive care faster. We have our own lab to create CAR-T cells on the WashU Medicine campus. It’s the only one like it in Missouri and means our patients get cutting-edge care in less time. Sometimes our patients have their CAR T-cell infusion eight days.   

Research & breakthroughs that help you

The doctors treating you at Siteman are also researchers. We call these WashU Medicine experts “physician-researchers.” They’re always looking for ways to make CAR T-cell therapy better. Here are some exciting things happening at Siteman:  

Universal CAR T-cells: Scientists are creating CAR T-cells that could work for any patient. You wouldn’t have to wait for your own cells to be collected and changed. Treatment could start right away.  

More cancer types: Right now, CAR T-cell therapy is part of the standard of care for blood cancers like leukemia, lymphoma, and multiple myeloma. But Siteman is testing it in other cancers.   

New types of T-cells: Doctors are creating different kinds of CAR T-cells that attack cancer in new ways. They’re also working on TCR T-cells, which are being tested for lung cancer and sarcomas (a type of bone or soft tissue cancer).   

How CAR T-Cell Therapy Works   

T-cells are white blood cells that protect your body. They find and kill germs and bad cells. But many cancers can hide from the immune system. T-cells can’t tell that cancer cells are harmful.  

CAR T-cell therapy changes this. Doctors add a special molecule called CAR (chimeric antigen receptor) to your T-cells. This molecule acts like a tracking device. It helps T-cells stick to cancer cells and destroy them.  

What Happens During Treatment  

CAR T-cell therapy has three main steps:  

1.) Collecting your T-cells  

A machine filters T-cells from your blood. This is called pheresis. It doesn’t hurt and takes a few hours. You might feel a little dizzy or sick to your stomach, but most people feel fine. Trained nurses will watch you the whole time.  

2.) Changing your T-cells 

Your T-cells go to a lab. Scientists add the CAR molecule to them. This process lasts several weeks. When they’re ready, the new CAR T-cells come back to Siteman.  

3.) Getting your T-cells back  

You’ll come to the hospital for this treatment. The CAR T-cells go back into your body through an IV. This only takes a short time. You’ll stay in the hospital for a few days so doctors can watch you. When it’s safe, you can go home.  

Possible Side Effects  

CAR T-cell therapy can cause a condition called cytokine release syndrome. This happens when the new T-cells wake up (activate) your immune system, which causes swelling in your body.  

You might get a high fever. Your blood pressure might go up or down quickly. In some cases, you may need to have oxygen. Physicians will want you to share any new symptoms with them. Even if they seem minor, you need to call your team.