Cancer Cells

New advances in the war on cancer: living cell therapy

On April 6, 2016, we discussed several new successful treatments against cancer in the Minnesota Spokesman-Recorder
article “Good news: We are winning the war on cancer.” This is an
update on one of those treatments we referred to then as combination
cell, or chimeric cell, therapy.

Researchers and reporters alike are now calling it “living cell
therapy.” It works well and has been approved to treat certain resistant
childhood leukemias and adult lymphoma. Unfortunately, results against
solid tumors are not yet favorable. Success rates as an FDA-approved
treatment is greater than 70 percent, which is remarkable considering
that, in the recent past, these cancers, failing traditional therapies,
were incurable.

There are particular types of immune cells called T-cells that are
the real powerhouses when it comes to fighting disease and cancer.
Doctors can perform a pretty slick trick where they extract a T-cell
from a patient’s body and mix it with a specific virus. That is why it
has been called combination cell, or chimeric cell, therapy.

This virus infects the T-cell and directs it to produce unique sticky
proteins on its surface that recognize novel proteins on the cancer
cells. They fit together like hand and glove. These living therapy
T-cells float freely in the blood and recognize blood-born malignancies.
They bind to the malignant cells in the blood and obliterate them.

This type of living cell therapy works best for specific blood-borne
malignancies, especially those of the liquid form, such as leukemia and
lymphoma. Here’s how it works:

Leukapheresis

Special immune T-cells are isolated from a patient’s blood using a
particular filter. These cells are then frozen and sent to a unique
laboratory that transforms them into living treatment cells.

Cell programming

In the lab, the T-cells are mixed with a specific virus that causes
the T-cells to make unique proteins on their surface that can later
recognize and stick to leukemia or lymphoma cancers cells.

Multiplication

These newly programmed T-cells are grown and multiplied over a
million-fold in the laboratory, so they are in large enough numbers to
fight cancer when they are needed later.

Quality review

The new group of programmed and multiplied cancer-fighting T-cells
are specially checked and screened to make sure that they have only the
desired cells with unique cancer-fighting properties.

Lymphocyte reduction

The number of lymphocytes in the patient is reduced so that when a
large number of the newly programmed lymphocytes (originally from the
cancer patient, but now grown to much larger numbers) can be more easily
given back to and accepted by the patient and can function at optimal
levels.

Living cell drug infusion

The newly programmed cancer-fighting T-cells are slowly injected back
into the cancer patient. This is done over several minutes.

Cancer cell death via cytokine storm

The cancer-fighting T-cells can sense what size job they need to do
and can increase their numbers even more inside the body, if needed.
They can then launch an all-out attack on the cancer cells, killing
them.

During this attack, the cancer-fighting cells release many substances
called cytokines that enable the most effective attack. This release is
called a cytokine storm. It usually occurs one to two weeks after the
T-cells are injected back into the cancer patient.

The cytokine storm can make the patient feel like they have the flu.
Oddly, that is considered a good sign, except in a few cases where the
storm can be so severe it can harm or even kill the patient. Doctors are
getting better and better at treating and handling the storm, so most
patients do well.

A costly process

The process of transforming normal immune T-cells into
cancer-fighting cells is called CAR-T production, for “Cancer Antigen
Receptor T-cells.” It is an extremely expensive process: Currently, the
cost to produce CAR-T cells for injection is just short of $500,000 per
treatment. Prices may come down as the techniques to develop CAR-T cells
improve.

Additionally, researchers are devising ways to make the CAR-T cells
recognize multiple targets on cancers cells rather than the single
target employed now. The ability to identify various targets on a cancer
cell will make the CAR-T cells more efficient and will increase the
number of successful treatments. There are over 50 CAR-T studies
underway.

In conclusion

Although the war on cancer is not over, I’m delighted to report that
right now we have some of the best tools ever available in the fight. In
fact, former president Jimmie Carter used some of these tools to have a
complete remission of malignant melanoma that metastasized to his
brain.

If you or a loved one is diagnosed with cancer, it’s not the same
prognosis that it was even a few short years ago. Talk to your physician
about a combination of therapies including traditional surgery,
radiation, and chemotherapy along with the new strategies including
CAR-T living drug cancer treatments and many other new cancer therapies.

The war on cancer has never looked better than it does today.

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