It was a pivotal moment for cancer therapeutics when Andrew Dodd became one of the first people in Australia to be infused with CART-T cell therapy. He had been administered his own cells which had been “reprogrammed” with added antigen receptors to start fighting his relapsed myeloma This remarkable outcome was not just a breakthrough for Andrew, but a glimpse into the optimistic future of cancer treatment. Treatment measures in the form of immunotherapies have been painstakingly slow with no respite for doctors or patients; forcing them to turn to treatments of chemotherapy and radiotherapy, which often have severe side effects.

Andrew’s story is just one example of how CAR (chimeric antigen receptors) T-cell therapy is redefining cancer care. As this revolutionary approach continues to evolve, it is transforming how certain blood cancers are treated, offering new hope to patients nationwide.

What is CAR T-cell therapy?

If you flip through the pages of your middle-school biology textbook, you’d recall the term ‘T-cells’, a type of white blood cell, tasked with the responsibility to identify and destroy any ‘abnormal cells’ to protect your body from infection.

Cancer cells are abnormal cells, but sometimes T-cells fail to recognise and demolish these dangerous entities. Due to genetic mutations, they multiply uncontrollably, allowing the cancer to grow and spread unchecked.

To circumvent this issue, scientists draw blood from the patient to separate and genetically modify the structure of the T-cells to have chimeric antigen receptors (CAR) on their surface; allowing the T-cells to recognise a specific protein (antigen) on other cell surfaces. These T-cells are then clinically multiplied and readministered to the patient’s body through infusion.

In other words, the T-cells are reprogrammed to better fight cancer through CAR T-cell therapy.

This process is clearly illustrated in a visual explainer video by the Peter MacCallum Cancer Centre, available here.

Source: National Cancer Institute. The Guardian.

However, this therapy is not without some downsides.

Most notably, Cytokine Release Syndrome, which is experienced by 80% of patients on some level due to the release of increased amounts of pro-inflammatory cytokines. The most reported side effects resemble septic shock, with fever, hypotension, tachycardia and hypoxia. The onset is usually experienced in three days with a duration of eight days.

CAR T-cell Therapy Landscape in Australia

Australian and International experience has strengthened trust in CAR T-cell therapy as a safe, effective, and durable treatment for blood cancer. Medical institutions have approval to use this treatment for B-cell acute lymphoblastic leukaemia (ALL), Adult Diffuse large B-cell lymphoma (DLBCL), Mantle cell lymphoma (MCL) and Multiple Myeloma.

Currently, four CAR-T therapies are approved in Australia, each targeting different types of blood cancers and specific patient groups.

In 2021, Commonwealth and State & Territory Governments in Australia funded two CAR-T therapies (namely, Kymriah® and Yescarta®) for relapsed and refractory forms of certain leukaemia and lymphomas. Since 2023, Tecartus® is also publically funded for patients (as per the Table below). Most recently in 2025, (MSAC) recommended to publicly fund Carvykti® for patients with multiple myeloma who have received at least four prior lines of therapy.

CAR T-cell therapy for solid cancers is yet to be approved in the country, but there is on-going research and clinical trials to create CAR-based treatments for solid cancers.

Centres offering CAR-T therapy

Presently, CAR-T therapy is offered in select centres within one or two hospitals per state. In 2023, as per Evohealth Australia report, there were 11 hospitals across New South Wales, Victoria, Queensland, and Western Australia that offer this treatment to eligible patients. Note, there additional sites offering CAR-T, this includes Townsville Hospital and Princess Alexandra Hospital and also few NSW sites (Liverpool and Royal North Shore Hospitals), which will be most likely be up and running later this year.

Source: Evohealth Australia

 

Gaps in Publicly Available Data

CAR T-cell therapy is a ground breaking treatment that requires strong real-world evidence to guide its future. However, collecting and sharing this data remains a challenge.

Clinicians have access to information through the Australasian Bone Marrow Transplant Recipient Registry (ABMTRR) but there are difficulties in procuring national-level data to provide a holistic view on the adoption and impact of this therapy.

Consequently, state and territory governments often rely on manual reports from treatment centres which creates a barrier when planning services and allocating funding.

CAR T-cell therapy may hold the key for advanced and effective cancer care but large-scale progress can only be achieved when industry professionals and lawmakers understand how patients are responding to this treatment through data on survival rates, side effects, and quality of life. Understanding the cost of delivering this complex therapy is essential for developing sustainable funding models- to achieve a brighter, cancer-free future we have dared to envision.

 

If you or your team is interested in more cancer insights from a hospital or epidemiology perspective please reach out to Dev Madeka or Prab PhD.