Immune therapy is promising in the fight against blood cancers: how does it work?

We are only at the beginning of the trials, but a treatment used to help the immune system fight against blood cancers is also very promising against solid tumors.

If successful, the treatment called CAR-T could revolutionize cancer treatment by being an effective option for a larger number of cancer patients beyond leukemia and other blood cancers.

According to a report from the American Association for Cancer Research, scientists presented the results of a Phase 1 clinical trial at the AACR 2019 annual meeting from March 29 to March 3. April.

Prasad S. Adusumilli, MD, says that patients with advanced solid tumors and metastatic tumors in the thoracic cavity usually see poor results even with treatment. CAR-T is a great option, but beyond blood cancers, it has had little success.

Now, Adusumilli and his team have come up with a new CAR-T cell that can succeed in solid tumors, and preliminary tests have shown that it's a promising new treatment.

CAR-T cellular therapy: how does it work?

CAR-T cell therapy occurs when doctors genetically modify a number of patient cells to help recognize and attack cancer. It was initially approved and used for leukemia and lymphoma, by injecting the modified immune system cells directly into the blood where the cancer is located.

The problem with other types of cancer is that the therapy has not been successful in cases where the cells have to go from the bloodstream to where the tumor is located, be it in the lungs, bad or other organs.

In addition, the proteins targeted by the therapy are also present in normal cells, which means that even healthy cells can be attacked by the modified cells.

For the study, Adusumilli and the rest of the team have developed a new CAR-T cell that could solve these problems. The AACR reports that the new mesothelin-targeting CAR-T cells, called IcasM28z, contain the "suicide switch" of Icaspase-9 that can trigger the destruction of all CAR-T cells when they occur. it has unexpected toxicity in the patient's body.

Early studies show great potential for CAR-T treatment

The trials included 19 patients with mesothelioma, as well as two other patients with lung and bad cancer already metastasized in the chest cavity. The modified cells were injected into the chest where the tumors were.

One patient underwent surgery and radiation therapy after treatment and continues to do well without additional treatments 20 months later.

Fifteen patients had their condition improve enough to start taking a medication for the immune system, and eleven were observed long enough for the results to be displayed. Of the 11 people, two went into remission due to cancer, and a relapse later. Six had their tumors narrowed, while three cancers got worse.

Of course, Adusumilli points out that these results are limited to the extent that researchers are only in phase 1 of the trials.

Nevertheless, the research suggests that CAR-T treatment could be further developed to treat different types of cancer patients.

"The novelty of our study is that CAR-T cells target mesothelin, the surface protein of cancer cells, which is expressed in most cancer cells and are then transported directly to the tumor site at the end of the tumor. using regional administrative techniques, "says Adusumilli. "If this approach succeeds, in the US, 2 million patients with solid tumors expressing mesothelin per year will be eligible for this treatment."

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