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Removing stem cells from storage is part of the CAR T-cell treatment process. Photo Credit John Wallace, VCU Massey Cancer Center.
A technician at VCU Massey Cancer Center removes biological samples from storage. Photo credit John Wallace, VCU Massey Cancer Center.
At Bon Secours Virginia Health System, Dr. Irvin and others have adopted a CMS (Centers for Medicare and Medicaid Services) Model. They’re one of 195 facilities across the country participating in this initiative designed to improve care and lower costs through comparative outcome assessment. Research done by each is shared with all. This includes looking at everything from nutrition, financial counseling, palliative care, rehab, family needs and other issues affecting the patient’s quality of life. The process puts systems in place so the patient is at the center of all healthcare providers’ conversations.
“Transplant has always been part of cellular therapy. We’ve been always looking at how do we use medications or how do we biologically trick the immune system into recognizing something it overlooked? How do we, if you will, give it a better pair of glasses?” John McCarty, MD Director of the Cellular Immunotherapies and Transplantation program at VCU Massey Cancer Center
“As a treatment society, we’re going to have to figure out how to either get this cost down or how to manage the toxicity of the costs to the patient. Cancer doesn’t discriminate. We shouldn’t be discriminating in treatment either. And so, figuring how we can balance the cost of exciting novel therapies with making these cutting edge therapies available to everyone, that has not been addressed yet. It’s not going to do a person any good if we cure their cancer but bankrupt them for several generations,” Dr. Irvin states.
Breakthrough plug and receptor genomic approaches VCU Massey Cancer Center is the first in Virginia to offer FDA-approved CAR T-cell therapy. John McCarty, MD with VCU explains, “CAR T-cells are literally genetically reprogrammed immune system cells from a patient’s own body that are reprogrammed to fight cancer.” “The initial studies that got these approved were in people we were sending to hospice,” he admits. “For a T-cell to recognize a cancer, get turned on and say ‘you’re bad’, ‘you’re going away’, it has to plug into a cancer cell the way you plug in an appliance. It needs to be grounded or it won’t turn on,” Dr. McCarty says. “CAR T-cells have created the prongs so we are able to reprogram those cells into expressing the specific prongs and the plug that we want it to have so it will recognize the cancer we’re trying to treat.” The process sends patients’ blood to a lab where T-cells are separated then subjected to viral reprogramming to re-educate the cells to fight a specific cancer. They’re expanded, frozen, then sent back to the patient location. Chemotherapy is administered to “give the T-cells some elbow room.”
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