For the first time in Brazil, a patient received cancer treatment with CART-Cell cells outside of a scientific study. The procedure was performed on January 9, at the Complexo Hospitalar de Niterói (CHN), in Rio de Janeiro. The 74-year-old man is due to be discharged from the hospital on February 6 after a month of observation.
CART-Cell was approved by the National Health Surveillance Agency (Anvisa) in 2022. Until then, it was only available for academic research. It emerged as a hope for patients with some types of cancer, such as lymphomas, acute lymphocytic leukemia and multiple myeloma, who did not obtain the expected results in two other previous therapies.
“CART-Cell represents a possibility of cure for patients who have already tried at least two other therapies without results”, says hematologist Luciana Conti, responsible for the procedure in Brazil.
Civil engineer Carlos Alberto Wagner, 74, was the first Brazilian to undergo therapy. The procedure was performed in a private hospital, with all treatment paid for by the health plan. He has diffuse large B-cell non-Hodgkin’s lymphoma and had already undergone three different types of treatment – two chemotherapy and one radiotherapy –, all without the expected result.
“We tried three treatments. When he found out that the disease was not over, he was a little angry”, says Wagner’s wife, Aldelúcia Porto Maciel Wagner.
According to the National Cancer Institute, for each year of the three-year period 2020/2022, around 625,000 cases of the disease will be registered in BrazilScience Photo Library – STEVE GSCHMEISSNER, Getty Images
***photo-person-being-examined-for-suspected-skin-cancerExtremely common in the country, skin cancer is characterized by the appearance of tumors on the skin in the form of spots or spots with irregular shapes. Related to prolonged exposure to the sun, exposure to artificial tanning beds or for hereditary reasons, the disease can be treated through surgery, radiotherapy and chemotherapy.miriam-doerr/istock
***photo-woman-without-blouse-with-symbol-against-breast-cancer-Breast cancer is caused by the uncontrolled multiplication of cells in the breast. Although it is common in women, the disease can also affect men. Among the symptoms of the disease are: pain in the breast region, hardened lump, redness, swelling and bloody discharge. Treatment involves surgery to remove the breast, chemotherapy, radiotherapy and hormone therapy.SCIENCE PHOTO LIBRARY/Getty Images
***photo-person-holding-symbol-representing-the-fight-against-prostate-cancerMore frequent in men, prostate cancer has the following symptoms: blood in the urine, difficulty urinating, the need to urinate several times a day and the delay in starting and finishing urinating. Surgery and radiotherapy are among the treatments for the disease.Getty Images
***photo-woman-holding-throatAlthough it may be related to hyperthyroidism, smoking, changes in sex hormones and diabetes, for example, thyroid cancer is still not well understood by experts. Despite this, treatments against the disease involve hormone therapy, radiotherapy, radioactive iodine and chemotherapy, depending on the case. get images
***special-lung-cancer.jpgLung cancer is one of the types with the highest incidence in Brazil. Related to the use or prolonged exposure to smoking, its main symptoms are shortness of breath, chest pain, recurrent pneumonia, bronchitis, bloody sputum and frequent cough. The disease is treated with chemotherapy, radiotherapy, or/and surgeryBSIP / Getty images
***photo-offering-cigarette-and-other-denyingIn Brazil, squamous squamous cell carcinoma has the highest incidence among stomach cancers. Treatments involve surgery or radiation therapy and chemotherapyiStock
***photo-man-lying-with-part-of-red-trunk.jpgStomach cancer is diagnosed after identifying malignant tumors spread throughout the organ and which may appear as ulcers. Related to infections caused by Helicobacter Pylori, the presence of ulcers and untreated chronic gastritis, for example, the disease can cause vomiting with blood or blood in the stool, frequent belly pain and constant heartburnSmith Collection/Gado/ Getty Images
***Drawing-uterus-with-cancer-outbreaks-in-the-cervixSymptoms of cervical cancer include intermittent vaginal bleeding, abdominal pain related to bowel or urinary complaints, and abnormal vaginal discharge. Treatment involves chemotherapy, radiotherapy and surgery.Science Photo Library/GettyImages
***photo-dentist-appointment-mouth-patientOral cancer is a disease that involves the presence of malignant tumors in the lips, gums, roof of the mouth, tongue, cheeks and bones. It is more common in men over 40 years old and has as symptoms wounds in the oral cavity, spots on the tongue and nodules on the neck, for example. Treatment involves surgery, chemotherapy and radiotherapy.Pexels
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CART-Cell
CART-Cell cell therapy – Chimeric Antigen Receptor T-Cell Therapy – is a procedure capable of combating hematological cancers using the patient’s own defense cells (T lymphocytes), modified in the laboratory and reinserted by infusion.
“By being genetically modified, T lymphocytes become more active against tumors in the blood”, explains the hematologist.
Carlos Alberto’s cells were collected on November 11 and sent to a laboratory in New Jersey, in the United States, where genetic modification of the cells was carried out to potentiate them. The genetic material returned to Brazil on December 27th and the patient was hospitalized a week later for preparations for the infusion.
The engineer underwent three chemotherapy sessions to immunosuppress his defense system and allow the enhanced cells to be able to replicate without difficulty, increasing the chances of success.
The doctor explains that the cells receive a kind of “potency” in the laboratory, with a target (the anti CD19) to attack the malignant cells in the body. This makes them able to visualize and destroy the cancer again.
After the genetic modification of the T lymphocyte carried out in the laboratory, the material is transformed into an injectable medication, applied in a single dose to the patient through infusion, as occurs in blood transfusions.
encouraging results
According to Luciana, Carlos Alberto has already passed the most critical phase after the infusion and may be discharged soon. The expectation is that this will occur on February 6, after completing 28 days of the procedure.
“The patient needs to be closely monitored for at least 28 days. It is a very critical moment, because like any medicine, there are adverse effects. One of them, the most serious, is what we call cytokine release syndrome, which is like an inflammatory storm. Therefore, there is little care at this stage”, reinforces the doctor.
Aldelúcia says that her husband reacted very well to the procedure and the family is hopeful that he will finally be able to heal. “Of course, we need to walk further in the coming days to understand better, but we are hopeful,” she says.
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