CAR-T: results of the year
The world's first cancer gene therapy cured 37 patients this year
And it did not lead to any fatal outcome
Polina Loseva, "The Attic"
On August 30, 2017 , a cancer gene therapy based on chimeric antigen receptors – CAR-T - was approved for the first time in the United States. Now there are results of its use in clinics. In short: the technique works (but not always), the side effects are not fatal.
CAR-T gene therapy is designed specifically to combat B-cell lymphoma, a blood cancer caused by the proliferation of B-lymphocytes. It is arranged as follows: the patient's own T-lymphocytes are taken away and a new gene is injected into them. This gene encodes a receptor that recognizes a molecule characteristic of all B-lymphocytes. Then the T-lymphocytes are multiplied, returned to the patient, and they are sent to kill the tumor B-cells.
CAR-T was officially approved more than a year ago, but it is still used infrequently. As a rule, classical chemotherapy is used first against B-cell lymphoma, and this works in about two thirds of patients. Those who have not been helped by chemotherapy are offered to transplant their own pre-multiplied blood stem cells. But this method is suitable only for half of the candidates, and helps only in 20% of cases. For the rest, CAR-T becomes the only hope.
On November 30, scientists summed up the results of the first year of using gene therapy in practice – this was required of them by the FDA when it gave its permission for the use of CAR-T. The full results are published in the journal New England Journal of Medicine (Schuster et al., Tisagenlecleucel in Adult Relapsed or Refractory Diffuse Large B-Cell Lymphoma). In total, 93 patients underwent therapy this year.
Of these, 37 managed to be cured completely, and another 11 "partially" (this means that at the time of summing up they were better, but a complete victory over cancer has not yet been won). Thus, taking into account these 11 "partial" cures, the technology worked in more than 50% of cases.
For comparison: According to previous studies, stem cell transplantation coped with B-cell lymphoma only in 26% of cases, of which only 7% completely.
Another important indicator is the number of side effects. After the approval of the first CAR-T therapy, trials of similar drugs by other companies began, and one of them was discontinued due to the death of a patient. The cause of death then was cytokine release syndrome – hyperreactivity of the immune system. Of the 93 patients treated with CAR-T, cytokine release syndrome was manifested in 23%. But, fortunately, we managed to cope with all the consequences, and no one was injured.
It is worth noting that Novartis physicians were engaged in the treatment, which created this technique, and the same scientists participated in the analysis of the results as in the development of therapy. Therefore, we will continue to monitor the use of CAR-T in the clinic, and at the same time, the success of the second gene therapy drug approved shortly after the first, Yescarta Gilead California Laboratory.
Portal "Eternal youth" http://vechnayamolodost.ru