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CAR-T Cell therapy: Harnessing the Immune System to Fight Cancer
Table of Contents
Cancer arises from the uncontrolled growth of abnormal cells, forming solid tumors. These cancer cells possess unique surface markers, called antigens, that can be identified by the immune system.A crucial component of this system is T-cells, which utilize a protein called FasL to eliminate cancer cells. When T-cells recognise cancer antigens, they become activated and initiate an attack on the tumor. However, cancer cells often develop mechanisms to evade immune detection and destruction. CAR-T cell therapy is an innovative immunotherapy approach designed to overcome these evasive tactics and empower the immune system to effectively target and destroy cancer.
Understanding CAR-T Cell Therapy
Chimeric Antigen Receptor T-cell therapy, or CAR-T therapy, is a type of immunotherapy that genetically engineers a patient’s own T-cells to recognize and attack cancer cells. Unlike conventional cancer treatments like chemotherapy, which target all rapidly dividing cells, CAR-T therapy is designed to be highly specific to cancer cells, minimizing damage to healthy tissues. The process involves several key steps:
The CAR-T Process: A Step-by-Step Overview
- T-Cell Collection: T-cells are collected from the patient’s blood through a process called leukapheresis.[[National cancer Institute – CAR T-Cell Therapy Process]
- Genetic Engineering: In a laboratory, the collected T-cells are genetically modified to express a chimeric antigen receptor (CAR) on their surface. This CAR is specifically designed to recognize a protein, or antigen, found on the surface of the patient’s cancer cells.[[FDA – Understanding CAR T-Cell Therapy]
- T-Cell Expansion: The CAR-T cells are then grown and multiplied in the lab to create a large enough dose for treatment.
- Infusion: The engineered CAR-T cells are infused back into the patient, where they seek out and destroy cancer cells expressing the target antigen.
Approved CAR-T Therapies and Cancer Types
As of September 2024, the U.S. Food and drug Administration (FDA) has approved several CAR-T therapies for specific blood cancers. These include:
- Acute Lymphoblastic Leukemia (ALL): CAR-T therapies like tisagenlecleucel (Kymriah) and brexucabtagene autoleucel (Tecartus) are approved for treating relapsed or refractory B-cell ALL in children and young adults.[[FDA – Kymriah Approval]
- Diffuse Large B-Cell Lymphoma (DLBCL): Axicabtagene ciloleucel (Yescarta) and lisocabtagene maraleucel (Breyanzi) are approved for adults with relapsed or refractory large B-cell lymphoma.[[FDA – Yescarta Approval]
- Multiple Myeloma: Ide-cel (Abecma) and ciltacabtagene autoleucel (Carvykti) are approved for treating relapsed or refractory multiple myeloma.[[FDA – Abecma Approval]
Potential Side Effects and Management
CAR-T cell therapy, while promising, can cause meaningful side effects. These can include:
- Cytokine Release Syndrome (CRS): A systemic inflammatory response caused by the activation of T-cells