A New Weapon in the War on Cancer: CAR-T-Cells

A New Weapon in the War on Cancer: CAR-T-Cells

“You have cancer.” Many other severe afflictions like Alzheimer’s Disease, Cardiovascular Disease, and Diabetes are guaranteed to get your attention. But the word cancer strikes fear in the hearts of the bravest people.

Did you know that…

In 2020, an estimated 1 603, 844,590 new cancer cases were diagnosed in the United States, and 602,347 died.

• The most common cancers are breast cancer, lung and bronchus cancer, prostate cancer, colon and rectum cancer, melanoma of the skin, bladder cancer, non-Hodgkin lymphoma, kidney and renal pelvis cancer, endometrial cancer, leukemia, pancreatic cancer, thyroid cancer, and liver cancer.
• Prostate, lung, and colorectal cancers account for an estimated 43% of all cancers diagnosed in men in 2020. For women, the three most common cancers are breast, lung, and colorectal, and they will account for an estimated 50% of all new cancer diagnoses in women in 2020.
• The rate of new cancer cases is 442.4 per 100,000 men and women per year (based on 2013–2017 cases).
• The cancer death rate is 158.3 per 100,000 men and women per year (based on 2013–2017 deaths).
• The cancer mortality rate is higher among men than women (189.5 per 100,000 men and 135.7 per 100,000 women). When comparing groups based on race/ethnicity and sex, cancer mortality is highest in African American men (227.3 per 100,000) and lowest in Asian/Pacific Islander women (85.6 per 100,000).
• As of January 2019, there were an estimated 16.9 million cancer survivors in the United States. Cancer survivors are projected to increase to 22.2 million by 2030.
• Approximately 39.5% of men and women will be diagnosed with cancer at some point during their lifetimes (based on 2015–2017 data).
• In 2020, an estimated 16,850 children and adolescents ages 0 to 19 will be diagnosed with cancer, and 1,730 will die of the disease.
• The estimated cost of cancer care in the United States in 2018 was $150.8 billion. In future years, costs will likely increase as the population ages and more people have cancer. Costs are also likely to increase as new, and often more expensive, treatments are adopted as standards of care.

The problems with Chemotherapy

There is no question that the standard treatment for cancer, chemotherapy (“chemo”), has saved countless lives. But it is not a smooth, pain-free treatment; some cancer patients have felt like they received a 1-2 punch combination from a professional boxer. The first punch is the disease, and the second is the treatment.

Here’s an analogy for chemo: What is needed is a sniper bullet precision, but chemo is more like a double-barreled shotgun. What is desperately needed is a new approach that gets the job done more efficiently and precisely.

Introducing CAR T-Cell Therapy

CRT T-Cell therapy is new and original. It is a unique blend of gene therapy, which is researchers altering a cell’s DNA to erase a flaw or insert a healthy gene, and immunotherapy, which heals by awakening a patient’s natural defenses.

T-cells are the immune system’s infantrymen, the first line of defense against harmful invaders. The shock troops of T-cells are called “killer cells” with a long memory of previous battles against harmful invaders. But killer cells have a weakness. Many cancer cells have a stealth-like Ninja ability to sneak past the protective walls of the killer cells.

The solution is to alter the T-cells to enable them to detect the invaders and annihilate them.

In 2010, an experimental treatment was used on a patient (BL) suffering from chronic lymphocytic leukemia (CLL). The patient had not responded to conventional cancer therapies and was on death’s doorstep. In a last-ditch “Hail-Mary” effort, he agreed that since he had nothing to lose, he was ready to try CAR T-Cell Therapy.

The BL’s physician drew his blood, separated his T-cells, and added a disabled, harmless human immunodeficiency (HIV) virus to the cells. These altered cells could do what HIV cells excel at penetrating human immune cells.

But here is the exciting news: instead of destroying BL’s immune system, the altered virus was programmed to protect his system by decoding the T-cells genome, getting inside the cell, and delivering its life-saving contents.

The results were life-saving for the once-written-off patient. He was on his way to a full recovery!

The full name of the “CAR” in CAR T-cells is Chimeric Antigen Receptor. It is an acknowledgment to chimera, the three-headed, fire-breathing monstrosity of Greek mythology; part snake, part lion, part goat.

CAR T-cells are a part assassin, part scout, and part claw crane in one small but potent package. The genetically altered product is called a receptor and is the scout finding malignant cells. Once these invading cells are found, CAR T-cells charge, bear-hug, and finish them off.

More good news

Research has found that CAR-T cells have staying power. The study stated that “Unlike antibody-mediated therapy, Chimeric Antigen Receptor-Modified T cells have the potential to replicate in vivo (inside the body), and long-term persistence could lead to sustained tumor control.”

2014 Novartis licensed CAR T-cell technology, and on August 30, 2017, the Food and Drug Administration (FDA) concurred. This is an especially crucial milestone since this is the first time the FDA has approved a cell-based gene transfer therapy. The Novartis brand is called Kymriah, a salute to Chimera.

What are the downsides of CAR T-cell Therapy?

That's a good question. First, the cost. The price of Kymriah is $475,000...UGH! However, more insurers and Medicare are slowly coming on board, and as the technology becomes more popular, there is a good chance the price will drop.

Second, CAR T-cell therapy is not a 100% guaranteed, sure-fire path to a perfect cure. Some patients have experienced severe side effects from the treatment, and cancer relapses can occur.

Third, and most important, while CAR T-cells can pillage and wreak havoc on liquid cancers like leukemia, they are thwarted and ineffective against tumors, which, regrettably, are the vast majority of cancer deaths from the four leading killers: breast, colon, lung, and prostate cancer.

But the good news is that research continues, and many oncologists feel that we are finally developing the tools to battle the cruel monster called cancer seriously.

References

https://www.cancer.gov/about-cancer/understanding/statistics

https://en.wikipedia.org/wiki/CAR_T_cell

https://pubmed.ncbi.nlm.nih.gov/30680780/

https://www.medicalnewstoday.com/articles/146136#outlook

Word Count: 1030