CAR-T cell therapy is a method of immunotherapy that has shown promising success in treating cancers such as non-Hodgkins lymphoma, multiple myeloma, and B-cell acute lymphoblastic leukemia. But with these exciting breakthroughs come worrisome limitations. CAR-T therapy can contribute to cytokine release syndrome, a potentially fatal complication of immunotherapy. There is also the time and effort involved in harvesting healthy T-cells and adapting them to contain the chimeric antigen receptor, or CAR, that makes them effective adversaries of cancerous cells. Lastly, it takes time and money to train clinicians in the methods associated with CAR-T cell therapy.
These limitations all combine to slow the progress scientists hope to make in using cell therapy as an accepted and effective cancer treatment. Still, researchers are making great strides in using CAR-T therapy to eradicate a scourge that has plagued mankind for centuries, as recent clinical trials have shown.
What’s Being Done With CAR-T Cell Therapy?
In the earliest days of CAR-T therapy, scientists experimented with this form of immunotherapy as possible treatment for ALL, or acute lymphoblastic leukemia. A 2010 clinical trial performed at the University of Pennsylvania and a 2012 study conducted at Children’s Hospital of Philadelphia led to the approval of tisagenlecleucel, a CAR-T cell therapy, to treat both children and adults with blood cancer. The treatment was FDA-approved after it proved to prompt a remission rate of over 80 percent. This was only the beginning of what scientists would eventually discover.
Flash forward to April of this year to a clinical trial that’s utilizing CAR-T therapy in addition to a MRNA vaccine to improve the prognosis of patients with solid tumors. The study is a multicenter, ongoing trial being spearheaded by researchers in the Netherlands that has shown early signs of positive results.
These trials, conducted over a decade apart, are indicative of the healing properties of this innovative form of immunotherapy. But there still remain challenges. Fortunately, science stands ready to find solutions, as recent breakthroughs suggest.
CRISPR Technology Could Halve the Time Needed to Obtain Healthy CAR-T Cells
Currently, scientists harvest the needed white blood cells from the patient who has cancer. This can be problematic because the amount of available healthy cells is often limited. However, using advances in technology, specifically CRISPR technology, researchers hope to create eventual storage “banks,” where modified T-cells from anonymous donors can be stored and used as needed. Not only would this make the treatment more widely available to patients around the globe, but it would also shave formidable time off T-cell preparation. Currently, the modified cells must be grown in laboratories, over a period of weeks, before there are enough to effectively reinfuse into the patient. Having prepared T-cells in ready storage would overcome this obstacle.
Advances are Being Made in the Treatment of Cytokine Release Syndrome
Cytokine Release Syndrome, or CRS, has been a stubborn side-effect of CAR-T therapy since the first clinical trials. CRS happens when an overwhelming supply of cytokines are released into the body in response to immunotherapy treatment. Symptoms of CRS include severe cold-like symptoms and multiple organ failure, which can result in death. However, scientists are learning how to derail CRS before it can become life-threatening. Current methods include using drugs such as tocilizumab, anakinra, or siltuximab at the onset of treatment to head off the most life-threatening side-effects before they can worsen.
What comes next for CAR-T cell therapy remains to be seen. But for cancer patients and their families, the future of this immunotherapy looks promising.