Diagnosis & Treatment

Cell Therapy

What are cell therapies?

Cell therapies use some of a patient's own immune cells to fight their cancer. They are made by modifying immune cells taken from a patient's blood or tumor so they can recognize cancer cells, multiplied to very large numbers, and returned to the patient to find and destroy tumor cells.

Types of cell therapies

CAR T-cell therapies: Some of a patient's white blood cells called T cells are engineered to produce chimeric antigen receptor ("CAR”) proteins, empowering these cells to recognize certain proteins or targets on the surface of cancer cells.
Tumor-infiltrating lymphocyte (TIL) therapy: TILs are white blood cells found inside tumors — evidence that the immune system is already trying to attack the cancer. TIL therapy is made from these white blood cells taken from a patient's tumor tissue to create billions of cancer-fighting cells.
T-cell receptor (TCR) therapy: TCR therapy gives T cells the ability to find and fight proteins hidden inside tumor cells, where most cancer-specific proteins are found.

What diseases can cell therapies treat?

CAR T-cell therapy is an option for some patients with diseases that cannot be successfully treated with standard therapies. At NewYork-Presbyterian, we use CAR T-cell therapy to treat people with:

Non-Hodgkin lymphomas (diffuse large B-cell lymphoma, mantle cell lymphoma, and follicular lymphoma)
Acute lymphoblastic leukemia (in children and adults)
Multiple myeloma
Autoimmune diseases, such as lupus and scleroderma (investigational basis, provided through clinical trials)
TIL therapy is used to treat metastatic melanoma.

How do cell therapies work?

CAR T-cell therapy

T cells are collected from the patient and genetically modified in a lab to make CARs. The CARs can target a protein on the surface of cancer cells. For example, certain leukemia and lymphoma cells have a protein called CD19 on their surfaces, and there are CARs designed to target CD19. The modified CAR T cells are multiplied and returned to the patient when the patient is ready. These cells seek out, attach to, and destroy cancer cells throughout the body.

TIL therapy

TIL cells are collected directly from the tumor. They are already primed to fight cancer, but their numbers are naturally low inside tumors. The TILs are then multiplied in a lab to create billions of them. When the TILs are returned to the patient, they seek and destroy cancer cells.

TCR therapy

T cells are collected from the patient's blood. They are genetically modified in a lab to make a TCR that specifically recognizes the tumor protein inside the patient's tumor. The engineered cells are multiplied and returned to the patient to fight cancer.

What to expect during cell therapy

Make an appointment: The first step is to meet with a cell therapy expert. To schedule an appointment, call us at 877-697-9355.
The evaluation: Our cell therapy experts will review your case and communicate with your referring physician to decide if this treatment is right for you. You will also meet with several members of our multidisciplinary teams, including nurses, advanced practice providers, social workers, and coordinators. If we decide that cell therapy is appropriate for you, you will have several tests to evaluate your health and make sure that this treatment is safe for you.
Removing the immune cells: Depending on the type of treatment you will receive, immune cells will be removed from your blood or from a sample of your tumor.
Making your cell therapy: We ship these cells to the manufacturer, who will engineer them for your treatment and then ship them back to us.
Preparing for the infusion: Before you receive the cell therapy, you will get chemotherapy to prepare your body for the treatment. This is called "lymphodepleting chemotherapy."
Receiving the cell therapy: After lymphodepleting chemotherapy is completed, the cell therapy is infused into your bloodstream (by vein), where the cancer-fighting immune cells will seek out and destroy tumor cells.
Monitoring your health: Following the infusion, we will monitor you closely for side effects, including daily checks, so they can be addressed as soon as possible.
Follow-up: After this initial monitoring period, you will continue to follow up with your cell therapy team to assess your response to the treatment and check for any late side effects.

Side effects of cell therapy

While very effective for targeting cancer, cell therapies can have certain side effects. Our multidisciplinary teams at NewYork-Presbyterian are highly trained to counsel you about these possible complications, minimize your risks, and provide immediate care if they occur. The main side effects of cell therapies include:

Cytokine release syndrome: When CAR T cells enter your body, they release cytokines — proteins that recruit other parts of the immune system. If this response is too strong, it can cause symptoms such as fevers and chills (in mild cases) and low blood pressure and difficulty breathing (in severe cases).
Immune effector cell-associated neurotoxicity syndrome (ICANS): Some patients who get CAR T-cell therapy may also experience side effects that involve the nervous system. These range from simple confusion and word-finding difficulties to seizures and brain swelling in severe cases.
Autoimmune-like effects: Skin rash, thyroid dysfunction, or muscle inflammation may occur in people receiving TCR therapy.
TIL side effects: Patients who receive TILs often also get a protein called IL-2 after the infusion, which can cause swelling, low blood pressure, and reduced blood flow to organs.

The care teams at NewYork-Presbyterian include experts in intensive care and neurology who are highly experienced in recognizing and treating these complications. They are also conducting research to better understand and prevent these problems.

Investigational therapies

Investigators at NewYork-Presbyterian are highly committed to cell therapy research to improve its effectiveness, reduce side effects, and extend its benefits to people with other cancers. Our programs have an onsite facility to manufacture new cell therapies. We are eagerly working on clinical trials to bring these treatments to more patients in need. Learn about our clinical trials.

Why choose us

NewYork-Presbyterian is home to some of the nation's most experienced healthcare professionals with expertise in cell therapies. These are intensive treatments, and we have all of the specialists and subspecialists you may need — here, onsite — to ensure your safety and health.