CAR-T enables amazing turnaround for Tri-County patient

“Few things frustrate an oncologist more than running out of treatment options,” says George Geils Jr., MD, Medical Director of the Blood and Marrow Transplant Program at Roper St. Francis Healthcare in Charleston.

That’s why he led the charge to bring CAR-T therapy — an advanced immunotherapy available at only 8% of hospitals in the country — to Roper St. Francis.

In one recent case, a patient with a large recalcitrant tumor achieved complete metabolic remission with zero side effects and returned to work within months.

Harnessing the potential and protecting against risks

Patients at Roper St. Francis have access to all FDA-approved applications of CAR-T, including recurrent or refractory cases of multiple myeloma and certain types of leukemia and lymphoma.

While the treatment can be life-saving, it is not without risks. Side effects like cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome can be quite serious.The team[1]  at Roper St. Francis prepares for the risk in two key ways:

“One is getting patients as close to remission as possible prior to infusing the new T cells,” explains Dr Geils. “The other is preemptively giving the patient molecules like tocilizumab, which can dramatically reduce the likelihood of an inflammatory reaction and readmission.”

Case study: From a large recalcitrant tumor to complete metabolic remission

Dr. Geils recently cared for a patient whose cancer and other health conditions made him a prime candidate for CAR-T. The patient had relapsed refractory diffuse large B-cell lymphoma, with a 14 cm abdominal mass that failed to remit with aggressive multi-drug therapy. The tumor abutted his major abdominal vessels and threatened one of his kidneys.

“His other option was bone marrow transplant. But because of his other medical conditions, we expected better results from CAR-T,” Dr. Geils says.

The process was smooth from start to finish. The team extracted the patient’s T cells without incident and sent them to the lab for reengineering. Then Dr. Geils applied intense chemotherapy in an attempt to maximize reduction of the lymphoma. Infusing the reengineered T cells went well, and afterward the patient experienced zero side effects: no fever, no malaise, no headache, no neurological toxicity.

“Six months out, he is in metabolic complete remission. The majority of patients who reach that point do not relapse after CAR-T,” says Dr. Geils.

Social support following treatment was the only complicating factor. Patients need someone to drive them around and be on-hand for up to 30 days after the T cell infusion due to risk of neurological complications. Since no one could serve that role for this patient, the team went the extra mile and admitted him.

“He spent four weeks being bored in the hospital. But sometimes boredom is great – you don’t want to be exciting when you’re a CAR-T patient,” Dr. Geils says.

Refer a patient to the cellular therapy team at Roper St. Francis

Call or Fax Referrals
Downtown, Mount Pleasant & West Ashley
Phone: (843) 402-1409 
Fax: (843) 606-8731

Epic
Referrals can also be made through EpicCare link

Online
charlestononcology.com/referring-physicians

Our team works to simplify scheduling and get patients from referral to diagnostics to care as quickly as possible. We can typically see your patients within 72 hours of referral.

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