CAR T FAQs

What is CAR T therapy?

CAR (chimeric antigen receptor) T cell therapy is a personalised form of immunotherapy that uses the patient’s immune system to target cancer cells.¹ Unlike other kinds of cancer treatment, it is made from T cells, which are a type of white blood cell.¹ The job of T cells is to target and remove bacteria, viruses and cancerous cells.^1,2 However, in some cases, cancerous cells have ways of hiding from T cells, which makes it difficult for the body to fight the cancer.¹

What is immunotherapy?

Immunotherapy is a treatment that uses the body’s immune system to kill cancer cells.³ CAR T is one type of immunotherapy that uses the patient’s immune system to target cancer cells.³ Checkpoint inhibitors are another form of immunotherapy and work by removing barriers that stop the immune system from finding and attacking cancer.³ Other types of immunotherapies stimulate the immune system to help it work better against cancer.³

When is CAR T used to treat blood cancer rather than other treatments like chemotherapy or radiation?

Different treatments are available to different people depending on their stage and type of blood cancer. These may include chemotherapy, radiotherapy, stem cell transplant, immunotherapy and CAR T therapy.^1,2 If one type of treatment doesn’t work or the cancer keeps coming back, it’s possible that another type of treatment could still work.⁴

CAR T therapy may be an option if certain cancer treatments haven’t worked, or the cancer has returned after treatment.⁴

How does CAR T work with the immune system?

CAR T therapy works by transforming T cells to help them identify and fight cancerous cells.¹ Normally, T cells help to find and fight off infections and cancer cells in the body.¹ Sometimes, T cells are not able to ‘see’ the cancer cells. This may allow cancer to grow.¹ CAR T therapy can help the T cells fight cancer again by adding a chimeric antigen receptor (CAR) to the T cells.¹ Once in the body, CAR T cells can help find and fight cancer cells.¹

What is the treatment process?

1. T cell collection:^1,5, T cells are collected through a process called leukapheresis. Blood is collected and filtered through a special machine that separates the white blood cells from other cells in the blood. These white blood cells are then sent to a laboratory where the T cells are isolated to be turned into CAR T cells.
2. CAR T cell manufacturing:^1,5 In a laboratory, T cells are inserted with a gene that causes them to produce chimeric antigen receptors (CARs). These newly modified CAR T cells are then multiplied for several days to produce the number of cells required for treatment. Once quality checks have been undertaken, these cells are frozen and sent back to the treatment centre, where they are thawed before infusion.
3. Preparing for treatment:^1,5 While the CAR T cells are being manufactured in the laboratory, there is a waiting period of a few weeks. During this time, patients may receive ongoing cancer treatment to keep their cancer under control. This is often referred to as bridging therapy. To prepare for CAR T therapy, patients will also undergo chemotherapy at the treatment centre. This treatment is intended to remove other immune cells to make more room for the CAR T cells to multiply once infused.
4. Infusion:^1,5 If the patient is well enough, they will receive a single infusion of CAR T cells. These newly modified cells may be able to find and fight the cancerous cells.
5. Monitoring:^1,5 After the infusion, patients are monitored carefully in the treatment centre by their healthcare team. Once discharged, patients must remain within easy access of the centre for at least 30 days after the CAR T cell infusion, for follow-up and urgent care if needed. Patients will also need to have a carer during this time, for support and to monitor for side effects.
6. Follow-up: The healthcare team will arrange follow-up appointments or ongoing care as needed.

Why is CAR T a once-only treatment?

CAR T therapy uses T cells that have been re-engineered to make them better able to find and destroy cancer cells.¹ Currently, CAR T therapy is designed to be a “once-only” treatment because the engineered T cells, once infused, can persist in the body and continue to target and destroy cancer cells.¹

Is CAR T a new form of therapy?

No, the first CAR T therapy was registered overseas in 2017.⁶ CAR T therapy has since become the standard of care for some forms of lymphoma and leukaemia.⁷ Thousands of patients have been treated worldwide with a CAR T product, and many more new CAR T therapies are being investigated in clinical trials.^8,9

Is CAR T safe?

CAR T products have been registered and funded in many countries around the world since 2017 and are the standard of care for some forms of lymphoma and leukaemia.^6,7 To be registered, products must provide significant safety data and undertake ongoing safety reporting to regulatory agencies. In Australia, this is the Therapeutic Goods Administration (TGA).¹⁰

Like all medicines, there can be side effects, and some can be serious. CAR T is only administered in hospitals by clinicians who are well-experienced in managing these side effects, and there is additional monitoring and support for patients who receive CAR T during and after their treatment.¹

What are the potential side effects of CAR T?

CAR T therapy, like many other treatments, has some side effects. Everyone’s experience is different – for some people, they won’t experience these side effects, for some people they’ll be mild, and for some people they may be severe.¹

CAR T therapy is only able to be given in certain hospitals where teams are experienced in managing some of the potential side effects of CAR T and specially set up for patients receiving this type of treatment. These highly trained teams are experts in managing the side effects of CAR T therapy.

What are the serious side effects of CAR T therapy?

Two of the most common side effects are neurological adverse reactions and cytokine release syndrome (CRS).

• Cytokine release syndrome (CRS):^1,5 After CAR T therapy infusion, the immune system can become overactive and release a large number of cytokines, leading to an inflammatory response. This can cause low blood pressure, fever, light-headedness, dizziness, shortness of breath, rapid heartbeat, chills, fatigue, weakness and headache.
• Neurologic adverse reactions:^1,5 After CAR T therapy infusion, a range of side effects can affect the brain or central nervous system. This can include confusion and disorientation, difficulty speaking and/or understanding speech, difficulty writing, short-term memory loss, tremors, agitation, increased sleepiness, fits, loss of consciousness and loss of balance or coordination.

As there are serious potential side effects, CAR T therapy can only be administered in certain hospitals where teams are experienced in managing the side effects and are specially set up for patients receiving this type of treatment. These highly trained teams are experts in managing the side effects of CAR T therapy.

Where is CAR T currently available in Australia?

CAR T can only be provided in certain hospitals that have appropriate training, procedures and facilities in place. To become a qualified CAR T treatment centre, the hospital must have specifically trained medical staff and strict treatment protocols and safety measures in place.

Eligible CAR T patients will be referred to the most suitable hospital for them. This could be their closest qualified treatment centre, or it may be the treatment centre where they have family or friends nearby to support them during their stay. Talk to your healthcare professional about funded travel and accommodation support that is available to access CAR T.

Below is the current list of qualified treatment centres. Additional sites may be added in the future.

New South Wales:

• Royal Prince Alfred Hospital, Sydney
• Westmead Hospital, Sydney
• The Children’s Hospital at Westmead, Sydney (paediatric indications only)

Victoria:

• Peter MacCallum Cancer Centre, Melbourne
• The Royal Children’s Hospital, Melbourne (paediatric indications only)
• The Alfred Hospital, Melbourne

Queensland:

• Princess Alexandra Hospital, Brisbane
• Royal Brisbane and Women’s Hospital, Brisbane
• Townsville University Hospital, Townsville

Western Australia:

• Fiona Stanley Hospital, Perth

Why can CAR T only be accessed at certain hospitals?

CAR T can only be provided in certain hospitals that are qualified to provide CAR T. Qualified CAR T treatment centres have specifically trained medical staff, strict treatment protocols, specialist equipment and safety measures in place to enable them to provide CAR T therapy to eligible patients. Each state and territory government in Australia decides which hospitals can be a CAR T treatment centre.

Why are there some states and territories that don’t have CAR T treatment centre?

Each state and territory government in Australia decides which hospitals can be a CAR T treatment centre. Currently, South Australia, Tasmania, Northern Territory and Australian Capital Territory do not have treatment centres. There are, however, discussions in some of these states and territories around future CAR T centres.

Additionally, CAR T can only be provided in certain hospitals that are qualified to provide CAR T. Qualified CAR T treatment centres have specifically trained medical staff, strict treatment protocols, specialist equipment and safety measures in place to enable them to provide CAR T therapy to eligible patients.

Can I still access CAR T if I live in a state or territory that doesn’t have a CAR T treatment centre, or if I live regionally?

Yes, if you are eligible for CAR T, your treating clinician will refer you to a CAR T treatment centre. Your treating team will discuss travel and accommodation support that is available for you and your carer to support you in accessing CAR T at a suitable centre.

What types of blood cancer is CAR T currently publicly funded (reimbursed) for in Australia?

As of May 2025, in Australia, CAR T is currently reimbursed for the treatment of the following:^7,11

Acute lymphoblastic leukemia

• Treatment of patients up to 25 years of age with B cell precursor acute lymphoblastic leukemia that is refractory or in second or later relapse. (Kymriah)
• Adult patients ≥25 years of age with relapsed or refractory B cell precursor acute lymphoblastic leukaemia. (Tecartus)

Large B cell lymphoma

• Treatment of patients with relapsed or refractory large B cell lymphoma after two or more lines of systemic therapy, including diffuse large B cell lymphoma (DLBCL) not otherwise specified. (Yescarta).
• Treatment of adult patients with relapsed or refractory diffuse large B cell lymphoma (DLBCL) after two or more lines of systemic therapy, not otherwise specified. (Kymriah)

Mantle cell lymphoma

• Treatment of adult patients with relapsed or refractory mantle cell lymphoma who have received two or more lines of therapy, including a Bruton’s tyrosine kinase (BTK) inhibitor, unless ineligible or intolerant to treatment with a BTK inhibitor. (Tecartus)

Follicular lymphoma

• Although CAR T has been registered by the TGA for follicular lymphoma, it is not currently funded and will be considered by the Commonwealth Government’s Medical Services Advisory Committee (MSAC) for public funding in 2025.¹²

Multiple myeloma

• The Commonwealth Government’s Medical Services Advisory Committee (MSAC) has recommended CAR T be reimbursed for multiple myeloma in patients who have received four prior lines of therapy. The manufacturer is in negotiation with federal and state governments to finalise reimbursement.¹³

How do I know if I am eligible for CAR T therapy?

Your clinician or Haematologist will need to assess your eligibility against the reimbursed criteria for CAR T and/or refer you to a CAR T treatment centre for assessment by the Haematologists at these centres. Talk to your treating clinician for more information.

How is CAR T publicly funded (reimbursed) in Australia?

CAR T therapy is considered a highly specialised therapy. These types of therapies are assessed for public funding (reimbursement) by the Commonwealth Government’s Medical Services Advisory Committee (MSAC) and are jointly funded by the Commonwealth and state and territory health departments.

Where is CAR T manufactured?

Manufacture locations vary by product, however currently all the TGA and reimbursed products are manufactured in the US or Europe by pharmaceutical companies. These products are manufactured in purpose-built, specialist facilities capable of producing large quantities of CAR T cell therapy products in a highly regulated and monitored environment, to supply patients around the world. Some clinical trial CAR T cell therapies, however, are manufactured locally in Australia.

Why do I need a carer to access CAR T cell therapy?

After having CAR T therapy, if you are an outpatient, you must have a full-time carer with you at all times and stay within a 30-minute drive of the hospital for a minimum of 30 days.¹ A carer is needed to monitor for side effects, support you with day-to-day tasks and take you to follow-up appointments.

Is CAR T suitable for patients with solid tumour cancers as well as blood cancers?

There are currently no CAR T therapies approved in Australia or elsewhere for the treatment of solid tumour cancers.⁹ There are, however, multiple clinical trials and research into CAR T in other forms of cancer, including solid tumours, along with neurological and inflammatory conditions.⁹

What support is available during and after CAR T therapy?

To be enrolled to receive CAR T therapy, the clinical team at the CAR T treatment centre will require you to have a carer to support you through the treatment phase and monitor you for side effects for a couple of weeks once you are discharged from the hospital. The nursing team at your CAR T treating centre will advise you more on this and provide information and resources to support you and your carer/s.

If you don’t live in the city/ town where the CAR T treatment centre is, you will need to travel to the centre for the apheresis (T cell removal) and then again for your CAR T cell therapy infusion. You will need to stay close to the treating centre for approximately 30 days after the infusion.¹ The CAR T cell manufacturing companies do, however, provide funded travel and accommodation services if you live more than 100 km from the centre. State governments and charities such as the Leukaemia Foundation also provide funding and/or housing support. Contact Rare Cancers Australia or Leukaemia Foundation for more information on what may be available to you, or speak to the nursing team at the CAR T treatment centre.

There are several support groups or services you can also connect to: