Immune System Therapy Could Play a Crucial Role in Curing Cancer

In medicine's continuing fight against cancer, a new treatment has surfaced and could possibly make a huge difference. The treatment helps the immune system fight deadly blood cancers and is showing early signs of promise against some solid tumors, giving hope that this approach might be extended to more common cancers in the future. The treatment, called CAR-T therapy, involves genetically modifying some of a patient's own cells to help them recognize and attack cancer. The therapy is named after the fact that chimeric antigen receptors or CARs are produced on the surface of a person's T cells-white blood cells that play an important role in the immune system-after collection of these cells from the blood.

Richard Carlstrand of Long Key, Florida, had it more than a year ago for mesothelioma, an aggressive cancer of the lining of the lungs. "We were going into unknown territories" to try this, he said, but now he shows no sign of cancer and "I couldn't be happier." Said a researcher an American Association for Cancer Research conference in Atlanta.

The first CAR-T therapies were approved in 2017 for some leukemias and lymphomas. After being altered in the lab, the modified immune system cells are returned to the patient through an IV, which puts them right where the cancer is, in the blood. But that approach doesn't work well if the cells have to travel far through the bloodstream to get to tumors in the lung, breast, colon, or other places.

"Solid tumors are notorious for not letting the immune cells enter," and not enough may make it in to have an effect, said Dr. Prasad Adusumilli of Memorial Sloan Kettering Cancer Center in New York. Adusumilli helped design a new CAR-T to try to avoid these problems and tested it on 19 patients with mesothelioma and two others with lung and breast cancer, respectively, that had spread to the chest lining.

After the therapy, one patient was able to have surgery and radiation and is doing well 20 months later with no further treatment. Fifteen others were well enough to start on a drug that boosts the immune system in a different way. A second study tested a different CAR-T therapy in 10 children and adults with advanced sarcomas or cancers that originate in various soft tissues or bones. Unlike other CAR-Ts that are usually given just once, this one was given multiple times, up to 15 in one patient's case, if there were signs it was helping.

These studies are showing there may be a path forward in solid tumors with CAR-T therapies, it may also hold promise for some cancers of the stomach, breast, colon, lung and other areas as well.

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