Chimeric Antigen Receptor (CAR) T-cell therapy is a well-studied immunotherapy that was developed in the 1980s. It can successfully treat blood and lymphatic cancers. It is a form of cell transfer that primes the body’s T-cells to kill cancer cells more effectively. (T-cells are a type of white blood cell. They stimulate the immune system and kill foreign cells, infected cells, and cancer cells). Given the success of CAR T-cell therapy in treating blood and lymphatic cancers, it is now being studied to treat solid tumors like malignant pleural mesothelioma.

How CAR T-Cell Therapy Works

Chimeric antigen receptors (CARs) are engineered to bind to unique components of a particular kind of cancer cell. Mesothelin is one such unique component of malignant pleural mesothelioma cells. In contrast to the mesothelin of normal tissues, the mesothelin of malignant pleural mesothelioma cells is unique because it is overexpressed, making it easier to target.¹ 

Once the desired CAR is designed, it is inserted into pre-collected T-cells via a viral vector or a non-viral alternative, known as a transposon.² This process changes the T-cells genetically so that they express CARs on their surfaces. Millions of CAR T-cells are replicated and then administered to the patient via intravenous drug infusion. At that point, the body’s T-cells are equipped to orchestrate a targeted immune response. The hope in CAR T-cell therapy for malignant pleural mesothelioma is that this targeted immune response would be robust enough to successfully treat the disease. 

Boosting CAR T-Cell Therapy with Other Immunotherapies

Because malignant pleural mesothelioma is so resistant to treatment, researchers are studying ways to boost the effectiveness of CAR T-cell therapy. One strategy they have developed thus far is to combine CAR T-cell therapy with other immunotherapies such as 

• Immunomodulator and monoclonal antibody drugs 
• Vaccines
• Cancer-killing viruses 

Side Effects and Possible Complications of CAR T-Cell Therapy

Common side effects of CAR T-cell therapy include 

• Fatigue
• Fever
• Chills 

These symptoms are normal parts of an immune response and indicative that the therapy is underway. 

In the event of the therapy overactivating the immune system, life-threatening but treatable complications can arise, such as 

• Dangerously high fever and low blood pressure
• Organ failure 

These complications are collectively known as the “cytokine storm” of an overactive immune response.