Guiding immune cells to attack

In 2018, we saw the first approval of a cell therapy for cancer. The technology,
called CAR-T cell therapy, consists of taking immune T-cells from the patient and
genetically engineering them to target a specific cancer antigen.

“CAR-T is changing the treatment paradigm for cancer by creating targeted treatments
that are specific to cancer cells,” said Christian Homsy, Executive Director of the board
of Celyad, a Belgian CAR-T developer. “Our goal is to develop precise, targeted
treatments that eradicate disease while sparing healthy tissue, and in doing so, improving
patient lives.”

Indeed, CAR-T clinical trials have shown impressive results in patients that relapse and
have exhausted other treatment options. However, the technology has also shown some
severe side effects that led to patient deaths.

“With the potency of CAR-T, what you want to absolutely ensure is that the target
antigen is not expressed on normal tissue, because if it is you can really wipe out organs
and potentially severely handicap or even kill the patient,” said Marett.
The technology is so far only available for treating certain rare forms of blood cancer. Several
players are developing a new generation of CAR-T treatments that can target a wider range of
cancers.

Among these players is Celyad. The company engineers T-cells to carry a molecule, borrowed
from another type of immune cells called natural killer cells, with the capacity to target 80% of
cancer cells. This could make it effective not only against blood cancers, but also in solid tumors,
which are a challenge for cell therapies.

“Celyad’s CAR-T approach exploits the molecular differences between cancer and healthy cells,
homing in precisely on the cells that cause disease. These targeted approaches will hopefully
lead to more tolerable treatments with higher efficacy and cure rates, particularly for patients
with limited treatment options,” said Homsy.

Another issue with the technology is its six-figure price. Part of the reason is that the therapy has
to be manufactured individually using each patient’s cells. Several companies are developing
off-the-shelf versions that can be derived from a donor with a simplified manufacturing process.
Celyad and the French company Cellectis, the first to run clinical trials with these off-the-shelf
cells, are among these.

These new and improved generations of CAR-T cell therapy are promising. However, they are
still in the early stages of clinical trials and will need a few years until they can reach the market.

Reaction:
The immune system is the body’s defense against infection and cancer. It is made up of
billions of cells that are divided into several different types. Immunotherapy is a type of
treatment that utilizes the body’s own immune system to fight cancer. In this article, T cells are
collected via apheresis, a procedure during which blood is withdrawn from the body and one or
more blood components are removed. T cells are known as “chimeric antigen receptor (CAR) T
cells.” CARs are proteins that allow the T cells to recognize an antigen on targeted tumor cells.
CAR T cells may eradicate all of the cancer cells and may remain in the body months after the
infusion has been completed. The therapy has resulted in long-term remissions for some types of
blood cancer. data providing information about early responses to therapy is fast emerging.
Researchers will be able to predict the duration of these responses after trial participants have
been followed over the long term. It is important for more pediatric and adult patients to be
enrolled in clinical trials. Larger study samples, evaluated over more extended periods, will help
researchers further understand the impact of this type of therapy, ways to reduce its toxicity and
improve the management of adverse side effects.

References:
Retrieved from: https://www.labiotech.eu/features/cancer-treatments-immuno-oncology/