CAR T-Cell Therapy for Mesothelioma

What Is CAR T-Cell Therapy?

CAR T-cell therapy is a form of immunotherapy that uses a patient’s own immune system to recognize and attack cancer. The term CAR stands for chimeric antigen receptor, which is an engineered receptor added to a cell of the immune system called T cells.

The engineered receptor acts like a guide, helping T cells recognize and seek out cancer cells carrying a specific protein found on the tumor. This allows the T cells to more precisely locate and attack cancer cells. In clinical trials for mesothelioma, the target protein is mesothelin, which is commonly found on the surface of mesothelioma cells.

CAR T-cell therapy is already FDA-approved for several blood cancers. As of March 2026, there are seven FDA-approved CAR T-cell therapies in the United States. CAR T-cell therapy is in testing as a mesothelioma treatment option.

What Are CAR T cells?

CAR T cells are genetically engineered versions of a patient’s T cells, which are cells of the immune system. T cells are a type of white blood cell that play a key role in helping the body defend against infections, disease, and cancer.

However, T cells don’t always recognize cancer cells easily. Cancer develops from the body’s own cells, which is how cancer cells can hide from the immune system and avoid detection.

CAR T-cell therapy uses genetic modifications to overcome this challenge by helping T cells better recognize and attack cancer. Scientists add a receptor, which works like a GPS system, helping the T cells find cancer cells carrying a specific protein.

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History of CAR T-Cell Therapy

The concept behind CAR T-cell therapy has been around for decades, but it really started gaining momentum in the early 2000s. One of the leaders in this research is Dr. Carl June at the University of Pennsylvania’s Abramson Cancer Center. Dr. June and his colleagues helped develop early CAR T-cell therapy approaches and tested them in clinical trials for leukemia and lymphoma.

At a time when gene therapy faced skepticism and limited funding, researchers like Dr. June continued exploring ways to enhance T cells with engineered receptors that could recognize cancer. Their work led to groundbreaking clinical trials in the early 2010s (2012 was the start of the trial), when some of the first patients treated with CAR T-cell therapy for leukemia experienced positive responses.

These successes helped establish CAR T-cell therapy as a new class of cancer treatment. The first FDA approval for a CAR T-cell therapy came in 2017, marking a major milestone for cellular immunotherapy.

FDA Approvals of CAR T-Cell Therapy

There are seven CAR T-cell therapies approved by the FDA for various blood cancers.

The seven approved CAR T-cell therapies are listed below with their brand names first and generic scientific name in parenthesis:

How CAR T Cells Are Made

The process of making CAR T cells begins with collecting blood from the patient. T cells are separated from the rest of the blood and sent to a manufacturing facility, where they are genetically modified to express the special receptor to help find cancer cells.

At the manufacturing lab, the cells are modified, multiplied, tested, and sent back to the treatment center. Doctors then infuse the cells back into the patient’s blood.

The overall manufacturing timeline can vary, but it commonly takes at least 2 weeks. In some settings, it may take closer to 3 weeks from collection to infusion.

In simple terms, the steps look like this:

CAR T Cells: A Living Drug and Cancer Vaccine

One reason CAR T-cell therapy has generated so much excitement is it is not a typical cancer treatment. These living and evolving cells become part of the immune system, possibly permanently.

After being returned to the body, the CAR T cells can continue to multiply and, in some patients, persist for extended periods to provide anti-cancer activity for years and even decades. This type of cancer therapy is very different from chemotherapy, which is metabolized and cleared from the body after each treatment cycle.

CAR T-Cell Therapy Survival Rates and Side Effects

Survival Rates

Survival for cancer patients receiving CAR T-cell therapy depends on which product is used, the type of cancer being treated, how advanced the disease is, and how well the patient responds. Because approved CAR T-cell therapies are only being used for the treatment of certain blood cancers at this time, the survival data comes from reviewing results from leukemia, lymphoma, and multiple myeloma patients.

The long-term results in some blood cancers have been impressive. In the 5-year follow-up of the ZUMA-1 trial, patients with B-cell lymphoma treated with axicabtagene ciloleucel (Yescarta) had an estimated 5-year overall survival rate of 42%, and some patients had ongoing responses years after treatment.

Kymriah, which is approved for a type of leukemia affecting children, had a complete remission rate of 85%. The survival rate for 1 year was 77%. Tecartus, which is approved for mantle cell lymphoma, helped patients reach a median survival of 46.6 months.

For mesothelioma, it is too early to report CAR T-cell therapy survival rates in the same way. The available clinical studies are small, early phase trials designed to test safety and feasibility. Even so, the results have been encouraging enough to support continued clinical development.

Side Effects

Like all cancer treatments, CAR T-cell therapy can cause side effects, though many are manageable with careful monitoring and early treatment.

The most common side effect is cytokine release syndrome (CRS). CRS occurs when CAR T cells activate and release large amounts of immune signals, called cytokines, that cause strong immune reactions. Symptoms may include:

• Fever
• Chills
• Fatigue
• Nausea
• Shortness of breath
• Rapid heart rate
• Low blood pressure

CRS usually occurs within the first few days after treatment and can often be controlled with medications such as tocilizumab, which is an antibody used to manage severe immune reactions.

Another potential complication is the immune effector cell-associated neurotoxicity syndrome (ICANS), which can cause temporary neurological symptoms such as confusion, headaches, or difficulty speaking.

Although these side effects can sound concerning, specialized treatment centers are experienced in managing them, and most patients recover with appropriate care.

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Can CAR T-Cell Therapy Work for Mesothelioma?

Mesothelioma immunotherapy is growing in popularity. There are several immunotherapy drugs approved for mesothelioma, but none of them are CAR T-cell therapies specifically. Still, the emergence of using immunotherapy to boost the immune system means there’s hope for a treatment like CAR T-cell therapy for mesothelioma.

Developing an effective cancer-fighting CAR T-cell therapy begins with identifying a specific protein to target. For mesothelioma, one of the most promising targets is the protein called mesothelin. This is a cell-surface protein commonly found on many mesothelioma cancer cells. 

Mesothelin is found in both pleural mesothelioma (affecting the lining of the lungs) and peritoneal mesothelioma (affecting the lining of the abdomen). Since this protein appears frequently in these cancers, it has become a key focus of CAR T-cell therapy research.

In a landmark 2007 review, Dr. Raffit Hassan and colleagues identified mesothelin as a promising target for immunotherapy. They noted that mesothelin is found in the majority of mesothelioma tumors but only limited amounts are found in normal tissues. While mesothelin can also be present in other cancers, including ovarian, pancreatic, and some colorectal cancers, it appears most consistently in mesothelioma.

CAR T-Cell Therapy in Mesothelioma Clinical Trials

Several early phase clinical trials are exploring mesothelin-targeted CAR T cells in patients with mesothelioma and other solid tumors. These studies have shown this approach is feasible and can be given safely. 

In a study at the University of Pennsylvania Abramson Cancer Center, mesothelin-targeted CAR T cells were safe and well-tolerated. However, the cells did not remain active in the body for long, and most patients experienced stable disease, meaning the cancer stopped growing, but the tumors did not significantly shrink.

One of the most important mesothelioma CAR T-cell therapy studies came from Memorial Sloan Kettering Cancer Center. In this study, researchers delivered mesothelin-targeted CAR T cells directly into the chest cavity of patients with pleural mesothelioma. 

The treatment was reported to be safe and well-tolerated. Among the mesothelioma patients who later received the immunotherapy Keytruda, median overall survival from CAR T-cell therapy was 23.9 months. 

Some patients experienced prolonged stable disease and a few even had complete remission.

Clinical development is continuing to move forward. Ongoing and recent trials continue to evaluate mesothelin-targeted CAR T-cell therapies for mesothelioma, including newer versions designed to last longer in the body and improve how effectively they attack cancer cells.

Frequently Asked Questions About CAR T-cell Therapy for Mesothelioma

How do CAR T cells treat mesothelioma?

CAR T cells are enhanced versions of your immune system T cells, which are white blood cells tasked with fighting infections, bacteria and other diseases. Cancer can withstand the attacks of T cells or sidestep their guarding of the body’s health. CAR T cells are modified to look for specific protein found on these cancer cells. For malignant mesothelioma, the protein targeted is mesothelin.

How do you get CAR T-cell therapy?

CAR T-cell therapy for mesothelioma is only available in clinical trials currently. The FDA approved six CAR T-cell treatments for various types of blood cancer, but no CAR T cells have been approved for solid tumors like mesothelioma. Clinical trials are your best option to receive this novel therapy.

What is the average survival for CAR T-cell therapy?

In clinical trials, CAR T-cell therapy has helped patients improve their mesothelioma life expectancy and survival. For blood cancers, this therapy has led to enormous success. Some patients are living a decade after their treatment. CAR T-cell therapy is different than other treatments because it is often a one-and-done treatment, meaning patients only need a single infusion. The hope is CAR T cells infused into the body replicate and create a living drug for years after the infusion.

Sources & Author

1. Mesothelin targeted cancer immunotherapy. European Journal of Cancer. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2265108/. Accessed: 06/03/2022.
2. A phase I trial of regional mesothelin-targeted CAR T-cell therapy in patients with malignant pleural disease, in combination with the anti-PD-1 agent pembrolizumab. Cancer Discovery. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/34266984/. Accessed: 07/19/2021.
3. CAR T Cells in Mesothelin Expressing Cancers. Clinicaltrials.gov. Retrieved from: https://clinicaltrials.gov/ct2/show/NCT03054298. Accessed: 06/03/2022.
4. Cure is a big word. Alliance for Cancer Gene Therapy. Retrieved from: https://acgtfoundation.org/story/june/. Accessed: 06/08/2022.
5. Approved CAR T-cell therapies for blood cancers. Alliance for Cancer Gene Therapy. Retrieved from: https://acgtfoundation.org/for-patients/approved-car-t-therapies/. Accessed: 06/08/2022.
6. Yescarta® Is First CAR T-cell Therapy to Report Five-Year Survival Data From Pivotal Study Showing Durable Long-Term Survival in Patients With Refractory Large B-cell Lymphoma. Gilead. Retrieved from: https://www.gilead.com/news-and-press/press-room/press-releases/2021/12/yescarta-is-first-car-t-cell-therapy-to-report-five-year-survival-data-from-pivotal-study-showing-durable-long-term-survival-in-patients-with-refract. Accessed: 06/06/2022.
7. Kymriah Safely Treats ALL and NHL in Real-World Setting. Cure Today. Retrieved from: https://www.curetoday.com/view/kymriah-safely-treats-all-and-nhl-in-real-world-setting. Accessed: 06/06/2022.
8. Five-year follow-up of ZUMA-1 supports the curative potential of axicabtagene ciloleucel in refractory large B-cell lymphoma. American Society of Hemotology. Retrieved from: https://ashpublications.org/blood/article/141/19/2307/494672/Five-year-follow-up-of-ZUMA-1-supports-the. Accessed: 04/06/2026.
9. A Phase I Trial of Regional Mesothelin-Targeted CAR T-cell Therapy in Patients with Malignant Pleural Disease, in Combination with the Anti-PD-1 Agent Pembrolizumab. Cancer Discovery. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/34266984/. Accessed: 04/06/2026.

About the Writer, David Statman

David Statman is a Content Writer for Mesothelioma Guide. He received both his bachelor's and master's in journalism from West Virginia University, and has been in medical publishing since January 2022. He previously worked in sports journalism, primarily reporting on West Virginia sports for a number of publications.

He lives in Delaware with his wife, dog and two cats, and avidly competes as a professional wrestler in the Philadelphia area.