Treatments that genetically modify a patient’s own blood cells are creating a powerful new weapon in the fight against cancer – possibly even the most powerful yet, according to a leading international specialist in children’s cancer. HEALTH met with Dr. Rabi Hanna* at Arab Health recently to learn more about this groundbreaking technique.
CAR T-cell Therapy
Next-generation CAR T-cell therapy uses genetic engineering to create a ‘living drug’ specific to an individual patient, and is a breakthrough treatment for those with particularly aggressive variants of lymphoma or leukemia. According to Dr. Hanna, it uses genetic engineering to create a ‘living drug’ specific to an individual patient.
He says the first applications of CAR T-cell therapy have been in treating blood cancers, such as types of leukemia or lymphoma, which are among the more common forms of cancer among younger patients’. “Early results of CAR T-cell therapy for treating pediatric and young adult patients’ are highly promising and exciting,” says Dr. Hanna. “They are the ultimate personal medications that are designed to fight leukemia forever because they stay within the blood as a living drug. CAR T-cell therapy introduces enormous potential in blood cancer treatment, particularly among patients’ aged under 26 stricken with relapsed acute lymphoblastic leukemia.”
To create the medication, doctors’ take blood from a vein in the arm, pass it through a machine that separates out the white blood cells – including the T-cells, a type of immune system cell – and return the rest of the blood to the patient’s circulation. The gene for a special receptor that binds to a protein on the cancer cell – called a ‘chimeric antigen receptor’ or ‘CAR’ – is added to the T-cells in the laboratory. Large numbers of this newly created ‘CAR T-cell’ are then grown over a 14 to 21 day period in the laboratory, and then infused back into the patients’ blood after receiving a few days of chemotherapy. “Already, we are seeing survival rates jump from very poor and almost always fatal, to as high as 73 percent overall survival at one year,” indicates Dr. Hanna.
CAR T-cell therapies are being developed for other blood cancers, including chronic lymphocytic leukemia, other forms of lymphoma, and multiple myeloma, according to Dr. Hanna, and many of these breakthroughs could have particular relevance to adolescent and young adult patients’. He says this is an age group that is often overlooked by cancer programs that focus heavily on children at one end of the scale, and those forms of disease mostly affecting older patients’, such as breast, lung, or colorectal cancer, at the other. “Most adolescents and young adults are provided the same treatments as much older adults, even when we now know that the disease biology is different in younger patients,” he says. “In addition, because they tend to be busy with school or work or parenting, young cancer sufferers are less likely to take part in critically important clinical drug trials that could yield breakthrough treatment options.”