A big thank you to Reese Ladak for submitting their MIMM 214 assignment to post on The Turret. This guest post may give you new hope about the future of cancer treatments!
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CAR T-Cell Therapy: A New Era in Cancer Treatments
Reese Ladak
“I’m sorry, the test came back positive. You have cancer.” – are words that no patient ever wishes to hear. Characterized by rapid and uncontrollable proliferation of cells, cancer research has the most funding–and with good reason, given how cancer death rates have decreased only 32% in males and 17% in females in 30 years (Close, 2015). Although conventional treatments like chemotherapy and radiation are effective, more than 35% of cancer patients in the US alone died in 2018 (Siegel, et al., 2018). Oncology treatments thus far have been not as effective as they are mentally, physically, and financially taxing on a person. This, however, will not be the case for much longer. Due to extensive research by scientists and biomedical engineers, a new branch of cancer treatment, CAR T-cell therapy, is on the rise (Maus, et al., 2014). In the near future, patients sitting in a doctor’s office will no longer skip a heartbeat when they hear the word “cancer.”
What is it?
As the name suggests, CAR T-cell therapy involves T cells, which are soldiers of the body that protect it from harm. Each T cell has a specific pathogen (or “enemy”) of the body that it targets and subsequently destroys. In CAR T-cell therapy, the pathogens are solely cancer cells, courtesy of the chimeric antigen receptor (CAR) (Pagel, 2017). The science behind CAR is simple: only cancerous cells carry the specific molecule which CAR has strong affinity for, and hence all the T cells carrying CAR will be targeted towards just cancerous cells (Guthrie, 2019). With that said, CAR inducing a higher degree of selectivity in T cells is the reason behind CAR T-cell therapy’s increased effectiveness compared to chemotherapy. The more conventional treatments, such as chemotherapy, are untargeted forms of treatment, meaning both cancerous and healthy cells are victims. Hence, the undesirable side effects of conventional cancer treatments, including hair loss, are no longer a concern for patients. Not only is it safer than chemotherapy, CAR T-cell therapy is much more convenient. With chemotherapy, patients must receive daily treatments. Contrastingly, patients undergoing CAR T-cell therapy require only one treatment, since CAR T cells autonomously fight the cancer to eradication (Tripathy, 2017).
Is it effective?
Based on a study done in 2016, where multiple CAR T-cell therapies were administered, it is! This study was trying to find the best way for CAR T-cell therapy to target cancerous cells, by evaluating different target molecules on cancerous cells that CAR may have high affinity towards. The study indicated that CAR T-cell therapy shows great potential. Based on the data based on more than 8,000 patients, it was apparent that blood cancers are much more treatable than solid tumours through CAR T-cell therapy. Furthermore, it was found that CD19 was the target molecule that was the most effective; a remarkable 80% of patients were completely cured of their cancer. The study also addressed a few flaws of CAR T-cell therapy, but, fortunately, they are quite manageable, and their severity is insignificant compared to that of cancer (Almåsbak, Aarvak, & Vemuri, 2016).
Should I care?
Yes, you definitely should – even if cancer is not a relevant part of your life. Cancer has been tormenting us for too long with requiring expensive, time-consuming and less than ideal treatments. Although current CAR T-cell treatments are far from perfect, such as being expensive and not 100% targeted towards cancerous cells, it is a major improvement from existing treatments–and it is only going to get better in the future. Current studies are trying to improve the selectivity of CAR T-cell therapy on blood cancers, as well as to introduce a way for the therapy to target solid tumours effectively (Sendra, 2018). Hence, a future where patients no longer have to worry about cancer is imminent.
References
- Almåsbak, H., Aarvak, T., & Vemuri, M. C. (2016). CAR T Cell Therapy: A Game Changer in Cancer Treatment. Journal of Immunology Research,2016, 1-10. doi:10.1155/2016/5474602
- Close, K. (2015, August 03). JAMA Paper Breaks Down Medical Research Funding in the US. Retrieved from https://diatribe.org/jama-paper-breaks-down-medical-research-funding-us
- Guthrie, G. (2019, January 24). CAR T-Cell Immunotherapy: The 2018 Advance of the Year. Retrieved from https://www.cancer.net/blog/2018-01/car-t-cell-immunotherapy-2018-advance-year
- Maus, M. V., Grupp, S. A., Porter, D. L., & June, C. H. (2014). Antibody-modified T cells: CARs take the front seat for hematologic malignancies. Blood,123(17), 2625-2635. doi:10.1182/blood-2013-11-492231
- Pagel, J. M. (2017, November 01). Chimeric Antigen Receptor (CAR) T-Cell Therapy. Retrieved from https://jamanetwork.com/journals/jamaoncology/fullarticle/2652907
- Sendra, J. W. (2018, May 23). What You Need to Know About CAR T-Cell Therapy for Cancer. Retrieved from https://healthblog.uofmhealth.org/cancer-care/what-you-need-to-know-about-car-t-cell-therapy-for-cancer
- Siegel, R. L., Miller, K. D., & Jemal, A. (2018). Cancer statistics, 2018. CA: A Cancer Journal for Clinicians,68(1), 7-30. doi:10.3322/caac.21442
- Tripathy, D. (2017, March 19). Weighing the Benefits and Risks of CAR T-Cell Therapy: The Stakes Are High. Retrieved from https://www.curetoday.com/publications/cure/2017/hematology-1-2017/weighing-the-benefits-and-risks-of-car-tcell-therapy-the-stakes-are-high