Personalized Medicine in Treating Cancer

A new emerging field of cancer treatment is T cell and dendritic cell therapy, and it is commonly referred to as “personalized medicine”. CAR-T cell therapy includes extracting T cells from a patient and manipulating these cells so they exhibit new receptors. These cells are then reintroduced into the patient’s body with the capability of producing chemicals to fight off cancer¹. These manipulated T cells will multiply in the body after being reintroduced and create an immune response. Although dendritic cell (DC) therapy is also a form of immunotherapy for cancer patients, it is different in that it manipulates dendritic cells rather than T cells. This therapy consists of extracting dendritic cells from the blood of a patient, exposing these cells to the patient’s specific cancer so they are “sensitized” to it, and reintroducing the “sensitized” cells into the blood so they can more efficiently fight off cancer².

Recently, T cell therapy has been approved to treat lymphoma, a cancer that affects the lymph system. In a clinical trial, Yescarta (a type of T cell therapy) was used, resulting in an 83% response rate, with 58% having a complete response. In a follow up of this trial, 47% of patients survived out of a population of 119 participants. In another clinical trial, KTE-X19 was used for mantle cell lymphoma, and this resulted in a 93% response rate, 67% complete response, and 83% survival rate³.

In addition, there have been clinical trials to study the effectiveness of T cell therapy in other cancers. For example, the effectiveness of CAR-T cell therapy has been studied in multiple myeloma, a cancer of plasma cells. Although this therapy has shown to be effective, its benefits are overshadowed by more severe side effects, like cytokine release syndrome. As a result, future studies need to come up with a solution to maximize the benefits of CAR-T cell therapy while minimizing side effects⁴.

Although T cell therapy shows promise in the field of cancer therapy, there are some drawbacks of this treatment. First, it is extremely costly. The two available T cell therapies, Kymriah and Yescarta, cost about $510,000 and $400,000, respectively⁵. Therefore, only limited populations would be able to afford this care. In addition, there are several side effects associated with the treatments. For example, cytokine release syndrome is common due to the multiplication of manipulated T cells in the body⁶. It can also cause neurological side effects such as confusion, seizures, tremors, and speech problems, but clinical trials are working to reduce these side effects by remodeling the therapy⁷.

I hope that these therapies continue to be researched and modified so that they can more effectively treat cancer patients and can be made more affordable to a wider population. Throughout my life, I have had 3 family members battle three different types of cancer, so this is a very important topic to me. I had never heard of this type of personalized treatment before researching for this blog, and I am very interested to see how this research continues to progress in future years.

References:

1. Verta, Jennifer. “CAR T-Cell Therapy & Mesothelioma Treatment.” Mesothelioma Hub. Accessed April 5, 2020. https://www.mesotheliomahub.com/treatment/immunotherapy/car-t-cell/.
2. “Dendritic Cell Therapy: Treatments.” Infusio. Accessed April 5, 2020. https://www.infusio.org/treatments/dendritic-cell-therapy/.
3. Weaver, C. H. “CAR T-Cell Therapy Treatment for Lymphoma – An Update.” Cancer Connect. Accessed April 5, 2020. https://news.cancerconnect.com/non-hodgkins-lymphoma/car-t-cell-therapy-treatment-for-lymphoma-an-update-TABHDEuu1UqYaINbQGN3Jw.
4. Wu, Chao et al. “Chimeric antigen receptor T cell therapies for multiple myeloma.” Journal of Hematology and Oncology. Accessed April 5, 2020. https://jhoonline.biomedcentral.com/articles/10.1186/s13045-019-0823-5
5. Zhao, Lijun, and Yu J Cao. “Engineered T Cell Therapy for Cancer in the Clinic.” Frontiers in immunology. Frontiers Media S.A., October 11, 2019. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6798078/.
6. “CAR T-Cell Therapy and Its Side Effects.” American Cancer Society. Accessed April 5, 2020. https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/immunotherapy/car-t-cell1.html.
7. NCI Staff. “Remodeled CAR T-Cell Therapy Causes Fewer Side Effects.” National Cancer Institute. Accessed April 5, 2020. https://www.cancer.gov/news-events/cancer-currents-blog/2020/car-t-cell-therapy-lymphoma-reduced-side-effects.