The foundation of cancer treatment has, for decades, been based on surgery. This approach drastically changed in the early 1900s with the development of radiation therapy.
The introduction, in the 1940s, chemotherapy, which aims to maximize damage to the rapidly dividing cancer cells, often at the expense of normal, healthy, cells, gave physicians another option to treat cancer.
Another major change came in 2003 after the completion of the Human Genome Project, which, for the first time in history had mapped the entire human genetic code. The results allowed scientists to get a better understanding of the biology of cancer and other diseases.
With a better understanding and new research tools, the past decade has been one of exploration, yielding revolutionary novel approaches to treating cancer. Scientists have developed a variety of novel classes of targeted therapies — therapies including antibody-drug conjugates and immunotherapies – which are now cemented as part of standard treatments for many cancers.
Immunotherapies—therapies that enlist and strengthen the power of a patient’s immune system to attack tumors—have emerged as what many in the cancer community now call the “fifth pillar” of cancer treatment.
A rapidly emerging immunotherapy approach is called adoptive cell transfer or ACT which involves collecting and using a patients’ own immune cells to treat their cancer.
There are several types of ACT, including Tumor-infiltrating lymphocytes (TILs), T cell Receptors (TCRs), and Chimeric Antigen Receptors (CARs).
Chimeric Antigen Receptors or CAR T-cell therapy has advanced the furthest in clinical development. The use of CAR T-cell therapy has, until recently, been restricted to small clinical trials, largely in patients with advanced blood cancers.
As a result of the remarkable responses they have produced in some patients for whom all other treatments had stopped working or never worked, CAR T-cell therapies have captured the attention of researchers and the public alike.
Today, 3 CAR T-cell therapies have been approved by the United States Food and Drug Administration (FDA).
- Tisagenlecleucel (Kymriah™; Novartis), was approved for:
- Adults with relapsed or refractory diffuse large B-cell lymphoma (DLBCL)
- Young adult patients up to age 25 with relapsed or refractory acute lymphoblastic leukemia (ALL)
- Axicabtagene ciloleucel (Yescarta™; Kite Pharma/Gilead) the first FDA-approved CAR T-cell therapy for adult patients with certain types of advanced B-cell lymphoma.
- Brexucabtagene autoleucel (Tecartus™; Kite Pharma/Gilead) is a FDA-approved CAR T-cell therapy for patients with relapsed or refractory mantle cell lymphoma (MCL).
After several decades of ongoing and painstaking research, the field of cancer therapies have reached a tipping point. In just the last few years, we’ve seen greatly accelerated progress with the development of novel and advanced treatments and scientists developing a better understanding of how these therapies work in patients and translating that knowledge into improvements in how they are developed and tested.
The expectation is that in the next few years we’re going to see dramatic progress when scientists are able to push the boundaries of what many people thought was possible with these adoptive cell transfer–based treatments.
CAR T-cells for Today, Tomorrow and Beyond
While CAR T-cells have been limited by several factors including high production costs and a lack of therapies applicable to a broad range of cancer types, companies are starting to explore new means to help unveil the true potential of CAR T-cell therapy.
For example, advancements are driving the evolution of CAR T-cell therapies toward ‘off-the-shelf’ – or allogeneic T-cells – which can be developed in advance from healthy donor cells to be available for multiple patients on an as-needed basis. These cells are modified to prevent or reduce the possibility of patients developing GvHD, the first hurdle to pass in order to kick off the development of ‘off-the-shelf’ CAR-T therapies.
- Also read: CAR T-cell Therapies for the Treatment of Patients with Acute Lymphoblastic Leukemia. Onco’Zine. October 13, 2020. [ Article ]
- Also read: Frequently asked questions about CAR T-cell Therapies [ Article ]
Highlights of Prescribing information
- Tisagenlecleucel (Kymriah™; Novartis) [Prescribing Information]
- Axicabtagene ciloleucel (Yescarta™; Kite Pharma/Gilead) [Prescribing Information]
- Brexucabtagene autoleucel (Tecartus™; Kite Pharma/Gilead) [Prescribing Information]
About The Journal
The International Journal of CAR T-Cell Therapy is a peer-reviewed, open-access journal published by Sunvalley Communication, the publisher of ADC Review | Journal of Antibody-drug Conjugates and Onco’Zine. The journal is set to premiere in the summer of 2021.
Submit a Manuscript
Submission of manuscripts and articles for inclusion in the International Journal of CAR T-cell Therapy opens in early 2021. Click on the links for more information:
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This page was last updated on October 20, 2020