Reviewed and edited by: Danielle Leonardo, M.D. Medical Oncologist

Your immune system has the power to fight diseases. Immunotherapy treatments help your immune system work better than it does on its own. Immunotherapy is being studied as a way to treat mesothelioma, an aggressive cancer.

CAR-T cell therapy is a type of immunotherapy that’s had some success against mesothelioma. Wondering how it works? First you need to know how T-cells work.

How do T-cells fight mesothelioma?

T-cells are a major part of your immune system. These cells are like powerful soldiers that fight and destroy dangerous things in your body such as cancer tumors. They have several ways of doing this, including releasing cytokines (chemicals that destroy harmful cells).

How do T-cells know when there’s danger around? T-cells are covered in tiny receptors that can attach to things. When these receptors attach to things called antigens, the T-cell knows there’s a harmful substance nearby. Mesothelioma tumors make antigens that T-cell receptors attach to, giving the cell a warning signal that gets it to start fighting.

How does CAR-T cell therapy work?

CAR-T cell therapy works by turning your T-cell soldiers into super soldiers.

First, doctors take some T-cells out of your blood. Then they put special receptors on the T-cells called chimeric antigen receptors (CAR). Think of this as giving soldiers specialized equipment to help them identify and fight a specific enemy.

Because the T-cells now have chimeric antigen receptors on them, they’re better able to identify and fight mesothelioma tumor cells. Now these enhanced T-cells are put back into your body.

When the T-cells find mesothelioma cells, they can identify them quickly. That’s because the chimeric antigen receptors on the T-cells attach to antigens from the mesothelioma cells. Then the T-cells go into combat mode, releasing cytokines and other chemicals to destroy mesothelioma cells.

How successful is this treatment against mesothelioma?

There aren’t many studies yet on how successful CAR-T cell therapy is against mesothelioma. The few studies out there show that CAR-T cell therapy reduced mesothelioma tumors in some people, helping them live longer. But it’s too early to say for sure that this is a solid, reliable treatment for mesothelioma. More research is still being done.

What are the side effects of CAR-T cell therapy?

Before you take CAR-T cell therapy, talk to your healthcare provider about the risk of side effects. The most common side effects are:

  1. Cytokine Release Syndrome (CRS): CRS is a widespread inflammatory response that can happen after CAR T-cell infusion. You may have a fever, flu-like symptoms, low blood pressure, or organ problems. CRS can range from mild to severe and may require medical intervention.
  2. Neurological Toxicity: Neurologic side effects can include confusion, seizures, and trouble speaking or understanding speech. These symptoms can be temporary or long-lasting, and you may need medical attention.
  3. Hematologic Toxicity: CAR T-cell therapy can lower your blood cell counts, including red blood cells, white blood cells, and platelets. This may cause anemia, increased risk of infections, and bleeding problems.
  4. Infusion-related Reactions: When CAR-T cells are infused back into your body, you may get a fever, chills, nausea, or headache. These symptoms are usually temporary and easily treatable.
  5. Organ Toxicity: In some cases, CAR T-cell therapy can damage organs such as the liver, kidneys, or lungs. Your healthcare provider will closely monitor your organs during and after treatment so they can quickly respond if problems come up.

Side effects are different for different people, so it’s hard to predict what will happen. Be sure to tell your healthcare provider if any of these conditions happens after you have CAR-T cell therapy.

CAR-T cell therapy is an immunotherapy treatment that can work on mesothelioma. Your T-cells already have the power to fight cancer, but CAR-T cell therapy makes the T-cells work better. This can reduce mesothelioma tumors and boost survival rates. The treatment may not work for everyone, but it has helped some people survive longer.