
Memorial Sloan Kettering medical oncologist Paul Hamlin treats people with lymphoma, including those with diffuse large B cell lymphoma.
For the second time in recent months, the US Food and Drug Administration has green-lighted a novel form of immunotherapy, called CAR T cell therapy, for the treatment of cancer. The approval is for axicabtagene ciloleucel (trade name Yescarta) for the treatment of people with aggressive diffuse large B cell lymphoma (DLBCL), a type of non-Hodgkin lymphoma. The cell-based product is made by Kite Pharma, which was recently acquired by Gilead Sciences.
A similar product from the drug company Novartis was approved in August for pediatric leukemia. Both cell-based treatments use genetically engineered versions of a person’s own immune cells to fight cancer. MSK researchers played a leading role in developing the technique.
DLBCL is the most common type of non-Hodgkin lymphoma, a blood cancer that primarily affects older adults. The typical treatment is chemotherapy using a combination of different drugs. This treatment may provide a cure but not always.
Previously, when a person relapsed after having therapy or stopped responding to treatment, a stem cell transplant was the only option. Now, CAR T cell therapy is a second potentially life-saving choice for people who may not be eligible for a stem cell transplant, or even for those whose disease has relapsed after having had one.
“For more than three decades, there has not been a single drug approved by the FDA for people with relapsed DLBCL,” says Anas Younes, Chief of the Lymphoma Service at MSK. “The approval of axicabtagene is a major step forward, providing a new effective treatment option for these patients. Our group is at the forefront of developing second-generation CAR T cells to further improve their efficacy.”
The FDA based its approval of axicabtagene ciloleucel on a clinical trial, led by Kite. The trial found that nearly half of people with this aggressive type of chemotherapy-resistant DLBCL had a complete response after receiving one infusion of CAR T cells, meaning all signs of their disease disappeared (at least for a time).
To make the cell product, doctors collect T cells from a person’s blood. The cells are frozen and then shipped to a lab where they are genetically engineered to contain a new gene. The modified cells are grown in the lab until there are billions of copies and then shipped back to the hospital for reinfusion into the person’s blood through an IV days later.

MSK is one of only a handful of cancer centers that have the experience and expertise necessary to administer CAR T cell therapies safely to patients.
“We have a multidisciplinary team of experts with vast experience who consult on every case,” says Sergio Giralt, Chief of the Adult Bone Marrow Transplant Service at MSK. “Our primary job is making sure that each patient gets the very best care — whether that’s CAR T cell therapy or another approach.”
Comments
Diane
Oct 31, 2017 • 6:10 PM
Dear Diane, although we don’t currently have any trials looking at CAR T for uterine cancer, we do have several trials looking at other types of immunotherapy for it. To see a complete list of our trials for uterine cancer, you can go to https://www.mskcc.org/cancer-care/clinical-trials/search?keys=uterine+c… Thank you for your comment.
James E. Kunz
Oct 31, 2017 • 6:11 PM
Memorial Sloan Kettering
Nov 1, 2017 • 10:53 AM
In reply to What drug co. produces this… by James E. Kunz
William J Sarver
Oct 31, 2017 • 6:35 PM
Memorial Sloan Kettering
Nov 1, 2017 • 12:50 PM
In reply to Will something like this be… by William J Sarver
Dear William, there are currently no CAR T cell therapies that are approved for the treatment of prostate cancer, but this is an active area of research. There is currently another type of immunotherapy that is FDA approved for prostate cancer, the vaccine called sipuleucel-T (Provenge). Thank you for your comment.
Alex Shaykis
Oct 31, 2017 • 6:50 PM
Memorial Sloan Kettering
Nov 1, 2017 • 12:41 PM
In reply to I am a patient with multiple… by alex shaykis
Dear Alex, Memorial Sloan Kettering is currently evaluating the effectiveness of CAR T therapy for treating multiple myeloma in a clinical trial. You can learn more here: https://www.mskcc.org/cancer-care/clinical-trials/17-025
If you are interested in arranging a consultation at MSK, you can call 800-525-2225 or go to https://www.mskcc.org/experience/become-patient/appointment for more information on making an appointment. Thank you for your comment, and best wishes to you.
Victor Arnone
Oct 31, 2017 • 7:13 PM
Memorial Sloan Kettering
Nov 1, 2017 • 12:03 PM
In reply to Dr. Younes saved my life… by Victor Arnone
Louise Gardner
Oct 31, 2017 • 7:14 PM
Memorial Sloan Kettering
Nov 1, 2017 • 12:21 PM
In reply to Can CAR T cell therapy be… by Louise Gardner
Dear Louise,
MSK does have a clinical trial looking at CAR T therapy for WM (The trial also treats patients with CLL.) You can learn more at:
https://www.mskcc.org/cancer-care/clinical-trials/16-1570
Or you can contact Dr. Jae Park at 212-639-4048.
To learn more about how MSK diagnoses and treats this condition, you can go to https://www.mskcc.org/clinical-updates/diagnosis-and-treatment-waldenst…
Thank you for your comment.
Sheldon Botkin
Oct 31, 2017 • 8:03 PM
Memorial Sloan Kettering
Nov 1, 2017 • 12:11 PM
In reply to can this help methothelioma… by sheldon botkin
Dear Sheldon, MSK currently has a trial underway to determine if CAR T therapy is effective in treating mesothelioma. You can learn more about the trial here: https://www.mskcc.org/cancer-care/clinical-trials/15-007
If you are interested in coming here for a consultation, you can call 800-525-2225 or go to https://www.mskcc.org/experience/become-patient/appointment for more information on making an appointment. Thank you for your comment, and best wishes to you.
William Napoli
Nov 1, 2017 • 1:46 AM
Memorial Sloan Kettering
Nov 1, 2017 • 10:56 AM
In reply to Will the treatment be… by william napoli
Steven U. Leitner
Nov 1, 2017 • 9:55 AM
Bill Dluzniewski
Nov 1, 2017 • 12:35 PM
Memorial Sloan Kettering
Nov 2, 2017 • 2:27 PM
In reply to why does one have to be… by bill dluzniewski
Dear Bill, chemotherapy is still considered the “first-line” treatment for diffuse large B cell lymphoma. If it is effective, patients don’t need to the get the CAR T treatment. Even when patients do receive CAR T, they are first given what is called conditioning chemotherapy to help their blood “make room” for the new engineered T cells. Thank you for your comment.
DAHER SHAHEM
Nov 5, 2017 • 8:03 PM
I was diagnosed with stomach CA( signed ring cell carcinoma, since march 2017 , I am under chemotherapy with taxol and Ramucirumab, I was stable andit control tumor to metastasize
now mount sini oncology dept. ask me to sign of trail of immunotherapy if my PDL positive, because I am smoker, despite my cancer is stable microcell, which is not respond to immunotherapy
should I go for this trail which is required to stop my standard chemotherapy during this period
what is you advice and recommendation
thank you
Memorial Sloan Kettering
Nov 6, 2017 • 8:59 AM
In reply to I was diagnosed with stomach… by DAHER SHAHEM
Dear Daher, we’re sorry to hear about your diagnosis. Unfortunately we are not able to offer medical advice on our blog. If you would like to make a consultation for a second opinion at MSK, you can call 800-525-2225 or go to https://www.mskcc.org/experience/become-patient/appointment for more information on making an appointment. Thank you for your comment, and best wishes to you.
Patricia Reed
Nov 22, 2017 • 12:26 PM
Memorial Sloan Kettering
Nov 27, 2017 • 4:19 PM
In reply to Can CAR T cell therapy be… by Patricia Reed
Genya Shpilsky
Nov 28, 2017 • 11:58 AM
Memorial Sloan Kettering
Nov 29, 2017 • 10:12 AM
In reply to I was diagnosed with non… by genya shpilsky
Dear Genya, we’re sorry to hear about your diagnosis. We do have trials for T cell non-Hodgkin lymphoma. If you are interested in learning more, you can call 800-525-2225 or go to https://www.mskcc.org/experience/become-patient/appointment for more information on making an appointment. Thank you for your comment, and best wishes to you.
Louis Miritello
Dec 5, 2017 • 9:25 AM
Memorial Sloan Kettering
Dec 5, 2017 • 11:06 AM
In reply to Any new breakthroughs with… by Louis Miritello
Dear Louis, we currently have several clinical trials for CLL. You can view the list here: https://www.mskcc.org/cancer-care/clinical-trials/search?keys=cll&disea…
If you are interested in making an appointment, you can call 800-525-2225 or go to https://www.mskcc.org/experience/become-patient/appointment for more information. Thank you for your comment.
Anne Magnuson
Dec 28, 2017 • 12:48 PM
My mother passed away from this at 69. She developed a blood infection after her third round of CHOP and almost died then. Imaging showed the CHOP was not effective at this point and it was discontinued. She passed away 10 weeks later. I don't know if she could have survived the chemo even if it had shown to be effective. I am curious if this treatment could be used as a first line treatment in cases where chemo is too toxic for the patient?
Memorial Sloan Kettering
Jan 1, 2018 • 2:06 PM
In reply to My mother passed away from… by Anne Magnuson
Sonos
Jan 11, 2018 • 2:44 PM
Dear Sonos, you can find the list here: https://www.yescarta.com/authorized-treatment-centers/
Thank you for your comment.
Colleen
Jan 17, 2018 • 7:40 AM
My husband has NHL/double hit and is currently undergoing chemotherapy. He has failed the EPOCH and is on RICE. We are discussing options going forward including stem cell transplant and car-t cell. If we have stem cell transplant and it fails or have a relapse can we still opt for car T cell. ? We have been told that we should have car T cell first and after remission opt for stem cell transplant
Dear Colleen, we’re sorry to hear about your husband’s diagnosis. We recommend that you discuss his treatment options with his healthcare team. If he would like to come to MSK for treatment or a second opinion, you can call 800-525-2225 or go to https://www.mskcc.org/experience/become-patient/appointment for more information on making an appointment. Thank you for your comment, and best wishes to both of you.
Stephen McClure
Mar 29, 2018 • 2:09 AM
Hi. I’m from Australia with B cell lymphoma. Rchop worked for a few months at best. Trial drug BGB3111 worked for a few months. Zydalig worked for a few months. I currently and trying to get into a period of reponse and then Bone marrow transplant. We have just started CAR-T therapy at Westmead Hospital however I was told that you must have a BMT first. From my research this does not appear to be the case.
Memorial Sloan Kettering
Mar 29, 2018 • 11:52 AM
In reply to Hi. I’m from Australia with… by Stephen McClure
Bob Hillerud
May 17, 2018 • 1:41 PM
Memorial Sloan Kettering
May 18, 2018 • 7:55 AM
In reply to My wife has Diffuse Large B… by Bob Hillerud
Dear Bob, we’re sorry to hear about your wife’s diagnosis. We recommend you discuss this with her cancer-care team. If she would like to come to MSK for a consultation, you can call 800-525-2225 or go to https://www.mskcc.org/experience/become-patient/appointment for more information. Thank you for your comment, and best wishes to both of you.
Ruth Bolliger
Jul 4, 2018 • 2:58 PM
Dx'd with Waldenstrom's Macroglobulinemia in late 2014. Two (out of 4 planned) doses of Rituxan dropped me into remission, but also very nearly killed me. 4 years later I am on Bendamustine with one more 2 day course to go. Numbers are down somewhat, but not very impressively.
I understand that WM is very rare, but is there really no research--or clinical trials--on it anywhere??? Do you know of any?
Thank you.
Memorial Sloan Kettering
Jul 5, 2018 • 8:03 AM
In reply to Dx'd with Waldenstrom's… by Ruth Bolliger
Dear Ruth, we’re sorry to hear about your diagnosis. We recommend that you go to www.clinicaltrials.gov to look for trials. Thank you for your comment, and best wishes to you.
Eric
Mar 10, 2019 • 5:44 PM
Jeanne Lowrey
Apr 4, 2019 • 9:41 AM
Dear Jeanne, we’re sorry to hear about your diagnosis. CAR T is not currently FDA approved for Burkitt’s lymphoma. If you are interested in learning what treatments MSK offers for this type of cancer, you can make an appointment online or call 800-525-2225. Thank you for your comment and best wishes to you.
Wendy Fogelstrom
Jul 31, 2019 • 1:07 PM
Memorial Sloan Kettering
Aug 1, 2019 • 8:21 AM
In reply to My mother is 80 yrs old and… by Wendy Fogelstrom
Dear Wendy, we’re sorry to hear about your mother’s diagnosis. There are restrictions on this therapy related to other health conditions. Some of them tend to be common in older people. We recommend you discuss this with your mother’s care team. If you are interested in arranging a consultation at MSK or learning what other treatments we offer for this type of cancer, you can make an appointment online or call 800-525-2225. Thank you for your comment and best wishes to both of you.
How about immunotherapy for advanced uterine cancer? It feels like that's the poor stepchild to breast and prostate cancer and lymphoma!