West Cancer Center’s, Jason Chandler, leads the way

By JAMES DOWD

For decades, cancer treatment has relied on surgery, chemotherapy, and radiation. Today, a new frontier is redefining what’s possible.

The rapid evolution of cellular immunotherapy continues to reshape the oncology landscape, with chimeric antigen receptor (CAR) T-cell therapy emerging as one of the most transformative advances in hematologic malignancies. At West Cancer Center, Jason Chandler, MD, is leading a program that reflects a broader shift by bringing highly specialized, potentially curative therapies out of academic centers and into community-based oncology practice.

“This therapy has been out for a while, but we launched it at West about a year ago,” Chandler said. “I think one of the amazing things about our therapy is that it’s delivered in a standalone clinic instead of a hospital setting. We provide treatment every day on an outpatient basis, so if patients tolerate it well and don’t need additional care, they’re able to return home after every session.”

CAR T-cell therapy is a form of immunotherapy that reengineers a patient’s own T cells to recognize and attack cancer. The process begins with leukapheresis, followed by genetic modification in a laboratory to add a chimeric antigen receptor (CAR), a protein that acts like a targeting system for cancer cells.

After expansion into hundreds of millions of cells, the therapy is infused back into the patient, where it continues to multiply. Genetic engineering enables a more effective strategy by reprogramming the patient’s own T cells to recognize and eliminate malignant cells.

But unlike traditional treatments, CAR T-cell therapy doesn’t stop working after infusion.

Jason Chandler

“Basically, you’re getting the body’s immune system to fight cancer. To do that, patients receive gentle chemotherapy of two drugs that puts their immune system asleep for a few days to allow the CAR T-cells to grow and expand,” Chandler said. “After decreasingly lower doses over a few days, the immune system comes back up on its own.”

The roots of CAR T-cell therapy trace back decades, including early immunotherapy research and breakthroughs in pediatric leukemia care at institutions such as St. Jude Children's Research Hospital. Since its first FDA approvals in 2017, the therapy has expanded rapidly, particularly in blood cancers like lymphoma, leukemia, and multiple myeloma.

Despite its potential, CAR T-cell therapy remains complex and costly, with treatment expenses reaching into the hundreds of thousands of dollars. Manufacturing timelines can take up to several weeks, leading to capacity limitations, and only a fraction of eligible patients receive treatment due to geographic, logistical, and institutional constraints.

In addition, CAR T-cell therapy has generally been concentrated in large academic centers such as MD Anderson Cancer Center, creating significant access barriers.

Still, momentum is building. New generations of CAR T therapies are in development, with the goal of improving efficacy, reducing side effects, and expanding into solid tumors.

And West’s program is working to address the challenges.

“In 2017, very few places offered it, and over the next several years even the big academic centers had to grow into it, and even those centers can’t treat everyone who needs this therapy,” Chandler said. “Only about 1 in 6 patients who need this treatment can get it, because their insurance may not cover it, and they may not have the resources to travel long distances to areas where it’s more readily available.”

West Cancer Center’s program is notable for its outpatient-first approach. Patients receive preparatory chemotherapy and CAR T-cell infusion largely outside the hospital, with close daily monitoring. If complications arise, patients are admitted through a partnership with Saint Francis Hospital. This hybrid model allows patients to remain closer to home while still receiving highly specialized care.

This model reflects an evolution in how the therapy is delivered. Early in its development, side effects like cytokine release syndrome (CRS) often required prolonged hospital stays. Today, earlier intervention has made treatment safer and more manageable.

Though still a young program, early outcomes at West have been encouraging. Initial patients, who are primarily in their 60s and 70s, have tolerated therapy well, with some requiring little to no hospitalization.

CAR T-cell therapy is currently approved for several hematologic malignancies, with particularly promising results in multiple myeloma, where a significant proportion of patients achieve long-term remission after a single treatment.

The program is now pursuing accreditation through the Foundation for the Accreditation of Cellular Therapy, a step that will expand access to more patients and insurance plans.

For Chandler and his colleagues, the mission is clear: make cutting-edge cancer care more accessible without requiring patients to leave their support systems behind.

As CAR T-cell therapy continues to evolve, its impact may extend far beyond specialized centers, reshaping how and where cancer care is delivered.

“I believe in the next 20 years this therapy will be used extensively for all kinds of cancer,” Chandler said. “We’re just trying to make it faster and more accessible and hoping that soon it becomes more affordable and accessible.”