Our most promising cancer treatments have not lived up to expectations. That could change in 2023.

Immunotherapy has rewritten the game when it comes to cancer treatment, earning it the label of a ‘fifth pillar’, behind more proven and true treatments such as radiotherapy, surgery and chemotherapy. And no other immunotherapy is garnering more excitement than CAR-T cell therapy. First approved in 2017 by the Food and Drug Administration to treat a form of acute lymphoblastic leukemiaAt the time, FDA Commissioner Scott Gottlieb called approval “A new frontier in medical innovation,” and the possibilities for CAR T seemed almost limitless.

Flashforward almost 6 years, and 6 therapies Approved for blood cancers such as lymphoma, leukemia, and multiple myeloma. When CAR T works, there’s no question that it works incredibly well. But researchers are baffled as to why it doesn’t work for most patients and types of cancer.

“We have patients who were out of options a few years ago and are now in long-term remission with this new treatment.” Jakub SvobodaAn oncologist at the University of Pennsylvania told the Daily Beast. “But what I’ve seen in my practice is that the number of patients who benefit significantly from this treatment as a third-line treatment for a type of lymphoma is still well below 50%.” he added.

This cell therapy could offer a cheap treatment for cancer patients

CAR T therapy has not yet been extended to treat solid tumors. majority of cancersImmunotherapy has been unable to break through the physical barriers, unique tumor cells, and suppressive microenvironment that characterize these cancers. researchers have highly effective small molecules that they hope will solve the low success rate of both hematologic and solid tumors. Known as “armored CAR Ts,” these infusions are fortified with a protective layer and an additional layer of cancer-fighting proteins. It is indicated that it may contain what is needed to

story continues

“We’re building these cells and sending them out on this very challenging adventure through different terrains and different problems, so we need to give them a set of tools.” Wendell Lima researcher in cellular and molecular pharmacology at the University of California, San Francisco, told The Daily Beast.

Simply put, immunotherapy can strengthen or restore the body’s immune system. reduce cancer cell defenses, Priming the immune system’s T cells to destroy tumors, or—in the case of CAR T-cell therapy—gene-editing the patient’s T cells. Scientists do this by isolating her T cells from the patient’s blood and inserting genes for chimeric antigen receptors. A chimeric antigen receptor is a type of synthetic protein that is specially made to bind to another protein on the surface of a patient’s cancer cells. These modified Her T cells are then injected into the patient, and the immunofighters recognize and destroy the tumor cells when the patient’s normal Her T cells fail.

At least that’s the idea. However, several factors may be involved if CAR T does not work. One is the tumor microenvironment, a set of chemicals and structures present in solid tumors that naturally suppresses resistance from the body’s immune system. Tumor heterogeneity is also a factor. Depending on the type and stage of cancer, tumor cells may not express proteins designed to be recognized by CAR T cell receptors, inhibiting the ability of CAR T cells to attack the cancer. Solid tumors have physical barriers on the outside that can even prevent T cells from getting inside and destroying the cancer.

Armored CAR T is designed to overcome these difficulties. In this form of treatment, T cells are not only engineered to express tumor cell surface proteins, but are also given potent cargo, often in the form of small proteins called cytokines. Deployed alone, such molecules can be toxic, but combining them with T cells designed to be released at the tumor site represents a promising new strategy.

This breakthrough cancer treatment has prevented leukemia relapses for more than a decade

Svodova is Help conduct clinical trials We are using armored CAR T-cell therapy to treat non-Hodgkin’s lymphoma patients who have failed previous CAR T therapies. last month he Published findings All of the first seven patients treated with this regimen responded and were alive eight months after receiving treatment. An important additional finding, according to Svoboda, was that the patient’s experienced toxicities (concerns about cytokines) were comparable to those with his conventional CAR T therapy.

Lim’s team is also working on an armored CAR-T therapy that could potentially be used to treat solid tumors.and Papers published in chemistry On December 16, he and his colleagues engineered T cells to release cytokines directly into pancreatic cancer and melanoma tumors in mice. The study found that these cancers were “almost completely resistant” to treatment with conventional CAR Ts, but the release of cytokines allowed genetically engineered T cells to pass through the tumor microenvironment. can effectively solve one of the problems that has set back treatment. .

CAR T-cell therapy makes incurable cancer curable

“The way we think about the future of CAR T-cell therapy is to develop reliable tools that solve specific problems and combine them into one package,” Lim said. We hope to begin patient trials of armored CAR T therapy within the next few days.

The process of getting these treatments to clinics is not quick. More trials are needed to confirm that the armored CAR T is effective while reducing toxicity as much as possible. Personalized immunotherapy can be time-consuming to produce (cancer patients don’t always have time) and is often expensive. Still, Svodoba said efforts are underway to make treatments more accessible, and if armored CAR T is effective in the long run, it may be worth the cost.

“If a single injection of an expensive product provides long-term remission or cure, investing in that type of product makes a lot of sense to me.

See The Daily Beast for more information.

Get the Daily Beast’s biggest scoops and scandals delivered straight to your inbox. Sign up now.

Stay informed and get unlimited access to the Daily Beast’s unparalleled reports. Subscribe now.