May, 15 2018
Armoring the body against cancer
For over a century, an extensive part of biomedical research has been focused on understanding and fighting cancer, involving thousands of oncology experts around the world. Common treatments such as surgery, chemotherapy and radiotherapy have increased and improved the life of millions of patients. However, they are highly invasive and expose the patients to external substances which are harmful not only to cancer cells, but also to healthy ones. What if we could fight cancer from the inside instead of from the outside? This is exactly what the foundation of immunotherapy relies on. It strengthens the immune system and makes it capable to fight and suppress cancer.
Within immunotherapy, there is a novel type of treatment that’s having increasing success in clinical trials with patients suffering from a blood cancer type called leukemia. This treatment involves a modified immune cell called Chimeric Antigen Receptor (CAR) T cell.
One of the remarkable examples of the successful experiences with this therapy is the case of Emily Whitehead. She suffered from leukemia in an advanced stage with low survival expectancy. Emily was the first person to receive the CAR T cell therapy. She had the quickest response the doctors had seen in the shortest period of time. Emily has been free of cancer for more than 5 years.
Notwithstanding, if this therapy is so promising, what are the challenges now? Several, because unlike Emily, other patients have presented dangerous side effects as an overactivation of the immune system or alterations of the nervous system. The major ones are finding the balance between the activation and control of the immune system with the CAR T cells, discovering new targets to tackle in the cancer cells and making this therapy effective to other types of cancer besides leukemia. It is exactly in these points where a vast part of the research of immunology is focusing this year.
Multiple groups of experts around the world are addressing these challenges, like the European Network on Anti-Cancer Immuno-Therapy Improvement by modification of CAR and TCR Interactions and Nanoscale Geometry (ENACTI2NG). In this network, young scientists from around the world collaborate in universities located in Germany, Spain, the Netherlands, Austria and England, undertaking the challenges mentioned above.
One of the members of this consortium is the University of Freiburg in Germany, where the research is led by Professor Wolfgang Schamel and Dr. Susana Minguet. This project is attempting to modify the design of the engineered components in the CAR T cells, introducing new molecules that are related to the activation, survival and growth of the T cells. The idea is maintaining the activation of the immune system to fight cancer but at the same time reducing the side effects. During the next years, the first results will come to light.Even though we still cannot predict how long it will take to design a therapy which can fight all types of cancer, the reality is that we are already living in a new era of cancer treatment: the CAR T cell therapy era.
MSc. Rubí Misol-Há Velasco Cárdenas
PhD Student on the improvement of CAR T cell therapy
Member of the ENACTI2NG consortium
Images from Juno Therapeutics and Parker Institute for Cancer Immunotherapy.