[Mike F]

Scientific American article on CAR T-cell therapy

by Mike F on Wed Nov 13, 2019 6:02 pm

Hi everyone,

I came across an article in Scientific American that I thought this group might appreciate. It provides an oncologist's perspective on the current use of CAR T-cell therapy for cancer treat­ment. Although it primarily talks about treating leukemia and lymphoma, I think the issues are probably similar for myeloma patients. The author talks a lot about the side effects, which are sobering, but it's a pretty optimistic article overall. It's here:

Yurkiewicz, I, "Behind the Scenes of a Radical New Cancer Cure," Scientific American, Nov. 9, 2019 (full text of article)

Excerpt:

Cancer, by definition, means something has gone very wrong within – a cell has mal­functioned and multiplied. The philosophy for fighting cancer has been, for the most part, creating and bringing in treat­ments from outside the body. That’s how we got to the most common modern approaches: Chemo­therapy (administering drugs to kill cancer), radi­a­tion (using high energy beams to kill cancer), and surgery (cutting cancer out with a scalpel and other tools). Next came the genetics revolution, with a focus on creating drugs that target a precise genetic mutation separating a cancer cell from a normal one. But cancers are genetically complex, with legions of mutations and the talent to develop new ones. It’s rare to have that one magic bullet.

Over the last decade or so, our approach shifted. Instead of fighting cancer from the outside, we are increasingly turning in. The human body is already marvelously equipped to recognize and attack invaders, from the com­mon cold to food poisoning, even if the invaders are ones the body has never seen before. Cancer doesn’t belong either. But since cancer cells come from normal ones, they’ve developed clever camouflages to trick and evade the immune system. The 2018 Nobel Prize in Physiology or Medicine was jointly awarded to two researchers for their work in immuno­therapy, a class of medications devoted to wiping out the camouflages and restoring the immune system’s upper hand.

What if we could go one step further? What if we could genetically engineer a patient’s own immune cells to spot and fight cancer, as a sort of “best hits” of genetic therapy and immuno­therapy?

Enter CAR-T. The technology uses T-cells, which are like the bouncers of the immune system. T-cells survey the body and make sure everything belongs. CAR-T involves removing a person’s T-cells from her blood and using a disarmed virus to deliver new genetic material to the cells. The new genes given to the T-cells help them make two types of proteins. The first – giving the technology its name – is a CAR, which sits on the T-cell’s surface and binds to a protein on the tumor cell’s surface, like a lock and key. The second serves as the T-cell’s caffeine jolt, rousing it to activate. Once the genetic engi­neer­ing part is done, the T-cells are prodded to multiply by being placed on a rocking device that feeds them nutrients while filtering their wastes. When the cells reach a high enough number — a typical “dose” ranges from hundreds of thousands to hundreds of millions — they are formidable enough to go back into the patient. Once inside, the cancer provokes the new cells to replicate even more. After one week, a typical expansion means multiplying by about another 1,000-fold.

[Kevin J]

Re: Scientific American article on CAR T-cell therapy

by Kevin J on Sat Nov 16, 2019 7:13 am

Thanks for the link Mike.

I'm always interested in finding information on this and similar research. My goal is to work through the currently available treatments, staying alive long enough until something potentially revolutionary like this becomes available. So far it's been working. I'm just approaching 9 years since diagnosis and still doing well. Looks like you're in much the same situation, having been diagnosed about a year after me at about the same age. Good luck with your treatment.

[Mike F]

Re: Scientific American article on CAR T-cell therapy

by Mike F on Mon Nov 18, 2019 12:43 pm

Thanks, Kevin!

My strategy has been the same as yours. I guess we're both lucky to have a version of the disease that is reasonably responsive to treatment, allowing for some time for new therapies to develop. With the way things are happening in this field, I think we have a good chance of getting pretty old before the myeloma gets us or something else does so first.

[WholeNotherWorld]

Re: Scientific American article on CAR T-cell therapy

by WholeNotherWorld on Mon Nov 18, 2019 1:19 pm

This is an excellent article. It is very clear and easy to understand. Thanks for posting the link!

[Christa's Mom]

Re: Scientific American article on CAR T-cell therapy

by Christa's Mom on Tue Nov 19, 2019 7:20 pm

Excellent article! Thank you for sharing. EJ and I also have the same thought. He was diagnosed in 2010.

Lyn