Cancer HorizonsAll NewsBlogsCaregivingDiet and ExerciseFinancialPsychosocialRecipesSexual HealthSide EffectSponsoredSurvivorship
All VideosCURE ConnectionsCURE Expert Connections®CURE Speaking OutCURE TVEducated Patient Sound BitesOn Demand: Webinars
Conference Coverage Conference Listing
CURE AdventuresCURE AwardsEducated Patient In Person EducationEducated Patient Virtual Education
Advocacy GroupsArt GalleryClinical Trial CornerHeal®PartnersPodcastsPublicationsShare Your Story
Subscribe
Blood CancersBlood CancersBlood CancersBlood Cancers
Brain Cancer
Breast CancerBreast Cancer
Childhood Cancers
Gastrointestinal CancersGastrointestinal CancersGastrointestinal CancersGastrointestinal CancersGastrointestinal CancersGastrointestinal CancersGastrointestinal CancersGastrointestinal Cancers
Genitourinary CancersGenitourinary CancersGenitourinary CancersGenitourinary CancersGenitourinary Cancers
Gynecologic CancerGynecologic CancerGynecologic CancerGynecologic CancerGynecologic Cancer
Head & Neck Cancer
Immunotherapy
LeukemiaLeukemiaLeukemia
Lung CancerLung Cancer
LymphomaLymphomaLymphomaLymphomaLymphoma
Myeloma
Rare CancersRare CancersRare CancersRare Cancers
Sarcoma
Skin CancerSkin Cancer
Thyroid Cancer
Spotlight -
  • Blogs
  • Breast Cancer Webinar Series
  • Cancer Horizons
  • Clinical Trial Corner
  • Heal®
  • Publications
  • Videos
Blood CancersBlood CancersBlood CancersBlood Cancers
Brain Cancer
Breast CancerBreast Cancer
Childhood Cancers
Gastrointestinal CancersGastrointestinal CancersGastrointestinal CancersGastrointestinal CancersGastrointestinal CancersGastrointestinal CancersGastrointestinal CancersGastrointestinal Cancers
Genitourinary CancersGenitourinary CancersGenitourinary CancersGenitourinary CancersGenitourinary Cancers
Gynecologic CancerGynecologic CancerGynecologic CancerGynecologic CancerGynecologic Cancer
Head & Neck Cancer
Immunotherapy
LeukemiaLeukemiaLeukemia
Lung CancerLung Cancer
LymphomaLymphomaLymphomaLymphomaLymphoma
Myeloma
Rare CancersRare CancersRare CancersRare Cancers
Sarcoma
Skin CancerSkin Cancer
Thyroid Cancer
    • Subscribe
Advertisement

CAR T Therapy for Relapsed/Refractory DLBCL: Brian’s Story : Episode 5

Video

November 25, 2020

Relapsed DLBCL: CAR-T Cell Related Side Effects

Author(s):

Loretta J. Nastoupil, MD, MD Anderson Cancer Center,Brian Gerberich, Patient

Video Player is loading.
Current Time 0:00
/
Duration 0:00
Loaded: 0%
Stream Type LIVE
Remaining Time -0:00
 
1x
    • Chapters
    • descriptions off, selected
    • captions settings, opens captions settings dialog
    • captions off, selected

      This is a modal window.

      Beginning of dialog window. Escape will cancel and close the window.

      Text
      Background
      Window
      Font Size
      Text Edge Style
      Font Family

      End of dialog window.

      This is a modal window. This modal can be closed by pressing the Escape key or activating the close button.

      EP: 1. A Diagnosis of Exclusion

      EP: 2.A Patient’s Initial Treatment for DLBCL

      EP: 3.A DLBCL Relapse During COVID-19

      EP: 4.CAR-T Cell Therapy for Relapsed/Refractory DLBCL

      Now Viewing

      EP: 5.Relapsed DLBCL: CAR-T Cell Related Side Effects

      EP: 6.CAR-T for DLBCL During COVID-19: A Caregiver’s Experience

      EP: 7.Relapsed DLBCL: Recovering After CAR-T

      EP: 8.Relapsed DLBCL: Assessing Response to CAR-T

      EP: 9.CAR-T for Relapsed DLBCL: Advice for Patients & Caregivers

      EP: 10.Managing DLBCL: A Team Effort

      EP: 11.A Journey Through DLBCL: Cautiously Hopeful

      Loretta J. Nastoupil, MD: You bring up some really good points, and one of the most important aspects of how we counsel patients about the potential adverse effects of CAR-T [chimeric antigen receptor-T cell therapy] is the unpredictability of those adverse effects, and also the severity can vary dramatically from one person to the next.

      But what I generally tell people is that we’re going to infuse these cells in you after we give you three days of chemotherapy. You’re going to have chemotherapy adverse effects in the background, so you’ll have a lot of fatigue. Blood counts are definitely going to drop, because that’s the point of that chemotherapy. It’s to clear out space so that your T cells that are out circulating are not going to want to remove or compete with those newly modified T cells we infuse in, and so a drop-in blood counts is what we’re hoping for. That puts you at risk for infection.

      You can also have nausea, sometimes diarrhea or constipation as a result of that chemotherapy. Then we throw this whole new thing at you, where we give you T cells that have been modified, so that once they engage their target, which is on the surface of your lymphoma cells, they’ll be super-activated. They will release cytokines, they’ll bring in reinforcements, whether it’s other CARs or other normal immune cells that haven’t been modified.

      You have this storm of the immune system trying to get rid of lymphoma cells. Oftentimes that will be followed by fever first, fatigue, muscle aches, flu-like symptoms. But the neurotoxicity is harder to predict.

      You received axi-cel [axicabtagene ciloleucel], which was the first FDA [Food and Drug Administration]-approved product for adults with large cell lymphoma, and the construct lends itself very well to rapid and successful manufacturing, but also higher rates of acute toxicity, both cytokine release syndrome and neurotoxicity.

      I think the neurotoxicity is what really sets it aside. We see as many as two-thirds of patients have some form of neurotoxicity, which we describe just like you recall, Denise. It could be some mild confusion, mild disorientation, slight trouble following simple commands or doing simple math and recall, to the extreme where patients don’t know who they are, they don’t know where they are, or what’s happening to them. They don’t know loved ones that they’ve known for a long time, to even sometimes being completely unresponsive both to verbal stimuli or even sometimes painful stimuli. Then worst-case scenario, we worry about seizure activity or even swelling of the brain that can be fatal.

      Fortunately, for the vast majority of patients who have the toxicity, it resolves on its own, sometimes with the use of corticosteroids or tocilizumab, which is an antibody that binds up those cytokines that are driving some of this toxicity. The vast majority of patients will fully recover.

      That’s good news for patients. Where we do a disservice is because we know the patient is going to recover and we know that the treatment is worthwhile, we may not counsel patients well enough for this rollercoaster ride. Brian, do you remember any of that?

      Brian Gerberich: There are several days that I don’t remember. I couldn’t remember my boys’ names and ages. I remember being asked things and I couldn’t respond. It was a weird experience. But again, we did get through it; I wouldn’t want to do it any time soon again. You made it very clear that that was a potential, and sure enough. But we were in a great hospital. We were very well taken care of, so we got through it.

      Denise Gerberich: I think we appreciated, too, the sense of urgency. I knew Brian was in good hands because everybody was so caring and took such great care of him. Even going through these challenging and difficult times that everyone had explained to me, I kept saying, “Are you sure this is normal?” because it definitely wasn’t normal to me. But being told that, “Yes, it’s going to be OK,” and being reassured that he would get through it and that it just would take a little bit of time. It was very helpful to me to have that reassurance.

      Transcript Edited for Clarity


      Newsletter

      Stay up to date on cancer updates, research and education

      Subscribe Now!
      Related Videos
      Image of doctor.
      Understanding AYA Lymphoma Care and Why Treatment May Differ by Age
      Image of Dr. Kelly
      Breaking Down Barriers to Diagnosis in AYA Patients With Lymphoma
      image of doctor D'Sa
      Mitigating Peripheral Neuropathy During Cancer Treatment
      Some patients with relapsed/refractory diffuse large B-cell lymphoma whose disease progressed after CAR-T cell therapy, responded to odronextamab.
      Odronextamab Elicits Responses in Some With Lymphoma Following CAR-T
      Image of woman with brown hair.
      Raising Awareness for Adolescents and Young Adults with Cancer
      Dr. Frederick L. Locke sat down with CURE® to discuss treatment with cema-cel in the ALPHA/ALPHA2 studies for relapsed/refractory large B-cell lymphoma.
      Breaking Down The Results of The ALPHA/ALPHA2 Study in Large B-Cell Lymphoma
      Treatment with cemacabtagene ansegedleucel demonstrated responses in patients with relapsed or treatment-resistant large B-cell lymphoma.
      Off-The-Shelf CAR T Therapy Elicits Responses in Large B-Cell Lymphoma
      Dr. Sattva S. Neelapu is a professor and deputy department chair in the Department of Lymphoma/Myeloma, Division of Cancer Medicine, at The University of Texas MD Anderson Cancer Center, in Houston, as well as a member of Graduate Faculty, Immunology Program, Graduate School of Biomedical Sciences, at The University of Texas Health Science Center, also located in Houston.
      Understanding the Challenges of CAR T-Cell Therapy Treatment in R/R NHL
      Dr. Sattva S. Neelapu, a professor and deputy department chair in the Department of Lymphoma/Myeloma, Division of Cancer Medicine, at The University of Texas MD Anderson Cancer Center, in Houston, as well as a member of Graduate Faculty, Immunology Program, Graduate School of Biomedical Sciences, at The University of Texas Health Science Center, also located in Houston.
      The Impact of Yescarta on Long Term Quality of Life in R/R Follicular Lymphoma
      Dr Sattva S. Neelapu discusses data from the ZUMA-5 trial investigating the CAR T-cell therapy Yescarta in relapsed/refractory follicular lymphoma
      CAR T-Cell Therapy Yescarta Continues to Demonstrate Durable Responses in Follicular Lymphoma
      Related Content
      Advertisement
      Linda Cohen is a survivor of small lymphocytic lymphoma and was diagnosed in 2009. Catch up on all of Linda's blogs here!
      May 9th 2025

      A Thank You to Nurses and the Support That Lasts Beyond Cancer Care

      Linda Cohen
      After cancer, lifelong infusions were tough — until nurse Angela’s care and kindness reminded me that true support can last long after treatment ends.
      CURE Cancer Horizons podcast logo
      January 29th 2024

      Prostate Cancer Headlines, CAR-T Warnings and Laughter Therapy

      Alex Biese Brielle Benyon
      CURE® editors discuss last week’s biggest cancer headlines, from Dexter Scott King’s death to the potential of laughter therapy to boost quality of life.
      Kim Johnson was a caregiver for her sister while she battled stage 4 Hodgkin Lymphoma for nearly five years, from diagnosis through an autologous transplant. Catch up on all of Kim's blogs here!
      May 7th 2025

      A Nurse Who Became Family After a Cancer Diagnosis

      Kim Johnson
      Eric Z. cared for my sister and mentored me with compassion, wisdom and unwavering presence — shaping my path in nursing and life.
      Top Headlines on CAR-T Cell Therapy
      December 4th 2023

      Top Headlines on CAR-T Cell Therapy

      Alex Biese Brielle Benyon
      From FDA concerns to a potential new drug, CAR-T cell therapies were dominating oncology headlines last week.
      Image of cells.
      May 4th 2025

      An Expert Offers Advice and Resources for Navigating Rare Lymphoma

      Ryan Scott
      Dr. Neha Mehta-Shah shares how patients can better understand their subtype of rare lymphoma, as well as expands on the challenges these patients face.
      Illustration of blood cells.
      May 1st 2025

      In Vivo CD19 CAR-T Leads to Remission in DLBCL Without Lymphodepletion

      Ryan Scott
      A patient with heavily pretreated relapsed/refractory diffuse large B-cell lymphoma achieved complete remission following novel in vivo CD19 CAR-T therapy.
      Related Content
      Non-Hodgkin LymphomaLymphomaCAR T Therapy for Relapsed/Refractory DLBCL: Brian’s Story
      Non-Hodgkin Lymphoma
      |
      Lymphoma
      |
      CAR T Therapy for Relapsed/Refractory DLBCL: Brian’s Story
      Advertisement
      Linda Cohen is a survivor of small lymphocytic lymphoma and was diagnosed in 2009. Catch up on all of Linda's blogs here!
      May 9th 2025

      A Thank You to Nurses and the Support That Lasts Beyond Cancer Care

      Linda Cohen
      After cancer, lifelong infusions were tough — until nurse Angela’s care and kindness reminded me that true support can last long after treatment ends.
      CURE Cancer Horizons podcast logo
      January 29th 2024

      Prostate Cancer Headlines, CAR-T Warnings and Laughter Therapy

      Alex Biese Brielle Benyon
      CURE® editors discuss last week’s biggest cancer headlines, from Dexter Scott King’s death to the potential of laughter therapy to boost quality of life.
      Kim Johnson was a caregiver for her sister while she battled stage 4 Hodgkin Lymphoma for nearly five years, from diagnosis through an autologous transplant. Catch up on all of Kim's blogs here!
      May 7th 2025

      A Nurse Who Became Family After a Cancer Diagnosis

      Kim Johnson
      Eric Z. cared for my sister and mentored me with compassion, wisdom and unwavering presence — shaping my path in nursing and life.
      Top Headlines on CAR-T Cell Therapy
      December 4th 2023

      Top Headlines on CAR-T Cell Therapy

      Alex Biese Brielle Benyon
      From FDA concerns to a potential new drug, CAR-T cell therapies were dominating oncology headlines last week.
      Image of cells.
      May 4th 2025

      An Expert Offers Advice and Resources for Navigating Rare Lymphoma

      Ryan Scott
      Dr. Neha Mehta-Shah shares how patients can better understand their subtype of rare lymphoma, as well as expands on the challenges these patients face.
      Illustration of blood cells.
      May 1st 2025

      In Vivo CD19 CAR-T Leads to Remission in DLBCL Without Lymphodepletion

      Ryan Scott
      A patient with heavily pretreated relapsed/refractory diffuse large B-cell lymphoma achieved complete remission following novel in vivo CD19 CAR-T therapy.
      Advertisement
      Advertisement
      Advertisement
      x
      About Us
      Advertise / Support
      Editorial Board
      Contact Us
      CancerNetwork.com
      TargetedOnc.com
      OncLive.com
      OncNursingNews.com
      Terms & Conditions
      Privacy
      Do Not Sell My Information
      Contact Info

      2 Commerce Drive
      Cranbury, NJ 08512

      609-716-7777

      © 2025 MJH Life Sciences

      All rights reserved.