Immunotherapy in a war against cancer

Doctors shoot at tumor cells

It’s perfectly normal you’re skeptical.

So am I.

It’s quite clear that, no matter how many times we try, we’re still losing this war. It’s terrifying to realize that cancer kills 8 million people every year, regardless of our efforts.

And it’s even more terrifying that this number increases each year.

Surgeries, chemotherapy, radiotherapy, and all other types of alternative treatments help us to win battles. But if we consider their negative effects and the high number of relapses, we can say that these battles we win are nothing but futile.

We never had fair odds in the war against cancer.

We are trying to destroy our enemy by shooting them with bandage covering our eyes. By doing that, we are killing our friends that can save our lives in the future.

There’s no hope.

Or yet, maybe there is?

THE SHIFT WITH IMMUNOTHERAPY

Every human has his own defense system that reacts to certain changes in his organism.

Even though our immune system is capable to differentiate variations in protein structure on its own, some infected cancer cells succeed to evade the system and cause destruction of the organism.

Immunotherapy, to some known as biological or biotherapy, wakes up the strength of our own immune system, and increases the organism ability to fight with the disease on its own. It gives the organism a possibility to win this battle.

Unlike the traditional treatments for curing tumors, such as chemotherapy, radiation or surgeries which kill not only the infected cells, but also the healthy cells in the human body, immunotherapy explicitly targets only the infected cells with some or no side effects.

 

future cancer therapy

 

Concept of immunotherapy isn’t new, and it dates back to 1940. and since then it has a limited application in medicine. New are the better results of immunotherapy and its expansion in different medical areas.

Most interesting thing for us are the preliminary studies that show almost unrealistically good results in treating severe malignant diseases.

NEW APPROACH IN THE FIGHT AGAINST THE EVIL

“The merging of gene therapy, synthetic biology and cell biology is providing new treatment options for patients with refractory malignancies and represents a novel class of therapeutics with the potential to transform cancer care.” – Stanley Riddell, Fred Hutchinson Cancer Research Center

Few months ago, we received a big news stating that the new generation immunotherapy showed “unprecedented” success in curing the even the most serious cases of blood cancer.

Stanley Riddell from Seattle’s Fred Hutchinson Cancer Research Center shared their preliminary findings stating that in one trial, 94 percent of patients with acute lymphoblastic leukemia reacted positively on immunotherapy treatment.

His team used the CAR T therapy (chimeric antigen receptor), and this treatment targets the CD19 antigen located on the surface of the infected cells.

Process begins with collecting T-cells (lymphocyte subgroup) from patient’s blood, which are then genetically reprogrammed and returned into patient’s organism. Once they are back in the bloodstream, they have a task to settle themselves in cancer cells via CD19 antigen, and then destroy them.

 

how t-cells work

 
This therapy only works for specific types of malignant diseases – such as acute lymphoblastic leukemia, chronic lymphocytic leukemia, and non-Hodgkin’s lymphoma.

It’s an open question if T-cells reprogramming can be used for treating other cancer types, and whether it can have an impact on other antigens as well?

The answer is a DOUBLE MAYBE…

T-CELL THERAPY (MAYBE) HAS A WIDER APPLICATION

Interesting data from a recent annual meeting of the American Association for Cancer Research (AACR) will provide us with a more comprehensive answer on our previous question. These data show that treatment with reprogrammed T-cells isn’t exclusively tied to a single antigen, nor a specific CANCER type.

Several research studies prove this thesis, and the most interesting ones are:

  1. Preliminary study of CAR T therapy by Juno Therapeutics shows that if patients stop producing CD19 antigen, some of them experience a relapse. But, in an extended therapy, these patients were successfully treated with CAR T therapy which was directed towards CD22 antigen. It showed that targeting both antigens is potentially the safest way to treat patients with previously mentioned blood diseases.
  2. Philip Greenberg from the Fred Hutchinson Research Center presented a possibility for WT1 antigen targeting. He uses a completely different approach named TCR (T-cell receptors). Unlike the CAR T therapy, his approach uses only human genes for reprogramming, and it can have an impact on proteins which aren’t located on the surface. This makes it potentially safer and more acceptable for different types of CANCER.
  3. Researchers from the University of Pennsylvania and Harvard University state that they found a way to impact the glioblastoma (the most aggressive brain tumor) by targeting CAR T therapy on the EFGRvIII, tumor specific, protein. A mini-study consisting of 9 patients showed unexpected safety and good results. As 30% of the patients with glioblastoma are EGFRvIII protein positive, further research of this therapy can have an immeasurably positive influence.

Wrap-up

Maybe my WAR-CANCER comparison sounds overblown, but it isn’t. Actually, it’s too mild. In period of 12 years, CANCER kills more people than all previous wars in the human history combined.

No matter how blind we are, it’s clear to us that we desperately need a powerful weapon. Is that weapon immunotherapy?

From this perspective, it’s hard to tell. Most of the studies we mentioned are still in their beginning phase, and they performed studies on a small number of patients. It will be at least two years before we get to see their long-term impact.

Maybe immunotherapy will never be the ultimate cure for CANCER. But if these studies get verified on a larger number of patients, in that case immunotherapy has a potential to prevent 20% of malignant disease related deaths.

That is roughly 1.5 million human lives each year.