T-cell Immunotherapy
In the United states, one person dies every nine minutes from a blood cancer, i.
e. leukemia, Hodgkin’s disease, and non-Hodgkin’s lymphoma, or NHL. That’s an estimated 160 deaths each day (lls). This paper is about why that number is decreasing more and more every year. Today, you will learn about non-Hodgkin lymphoma and how it’s treated, and the new experimental treatment that uses your own body’s own immune system to fight the cancer.
All of your body’s cells are created and programmed when you’re still inside of the womb. Your immune system’s cells are programmed so that they can only attack bad bacteria that comes from outside of your body, which is a good thing, because otherwise your body would destroy itself. The only problem with that is that when a type of cell becomes cancerous, your body can’t fight it off. A cell becomes cancerous when a mutation causes them to multiply out of control. The cancerous cells then crowd other cells out and make it hard for your body to function.
In NHL, a type of cell in your immune system, called a B cell, becomes cancerous, and your body isn’t able to fight it off. Then the cancerous B cells can spread to different places in your body and, if the cancer is bad enough, can shut down vital organs you need to survive. These are a few of the different types of treatments for NHL, including: Surgery Radiation Therapy Chemotherapy Bone Marrow Transplants (Cancer Research UK) But sometimes these treatments are short-lived, meaning they can help the patient’s lymphoma, but eventually stop working. Other times the patient may show no response at all. That’s when the patient and their family have a few choices. There are a few other options for treatment after that, or if the lymphoma is fatal, the patient can be accepted into hospice.
One of the treatment options is enrolling in a clinical trial. A clinical trial is “any research study that prospectively assigns human participants or groups of humans to one or more health-related interventions to evaluate the effects on health outcomes.” (Who) A recent clinical trial has been so effective that hospitals and cancer research organizations have been putting money and effort into trying to improve and make official the treatment. The race for a breakthrough is slightly aggravating because lots are doing it just for the money, while others are doing it for both the money and to help people, and a few are doing it just to help. Obviously, I’m not old enough nor do I possess enough (any) degrees, but I have been following this trial avidly for the past year-ish.
Why? Because during the most recent trial done (December 2016) 93% of the patients saw their cancer disappear while participating. Also because my dad died of lymphoma in July of 2015. This new way of killing cancer is called CART therapy, a type of immunotherapy. Immunotherapy is using a person’s own immune system to fight a disease, in this case: cancer. CART stands for Chimeric Antigen Receptor T-cell therapy.
This treatment also goes by ctl019. It sounds really confusing at first, but when you know the terms, it’s easy to understand. I’ll explain it for you. B cells, which I talked about earlier, work alongside their partners, T cells. The job of a B cell is to make antibodies that recognize and attach themselves to antigens, which are toxic cells from outside of your body.
Then other cells in your body can recognize the antigens and destroy them. T-cells destroy other antigens in your body directly. But like I said earlier, when your cells are created, they are programmed so that they can’t hurt other cells in your body. That’s where CART therapy comes in. It’s where the T-cells froma patient’s body are extracted through the blood, and taken to a lab.
Then, in the lab, the T-cells are genetically modified to recognize and attack a protein on the surface of the B-cells. The proteins they are modified to recognize are called chimeric antigens. Now does the name make more sense? The T-cells are then shipped back to the hospital where they are transfused back into the patient’s bloodstream. Then they go to work killing all the B-cells in the person’s body. Cancer gone, right? But the treatment isn’t perfect. Sometimes during treatment, a patient’s immune system can go haywire from the T-cells multiplying and releasing too many cytokines (small proteins involved in cell signaling) when put back in the body.
This causes CRS, or Cytokine Release Syndrome. CRS causes nausea, low blood pressure, fatigue, severe fevers, organ swelling, and difficulty breathing. Imagine having the stomach flu, diabetes, and severe asthma all at once. It can even be fatal. Patients who have developed severe CRS have died during clinical trials of CART therapy.
So, you ask, why risk death for a possible cure? Because it’s being proven effective as we speak. Safety measures are improving, hospitals are helping,major pharmaceutical companies are investing, and society is involved! And here’s the upside to those companies who are in it for the money: this trial has shown so much progress that they have invested their own money in developing it even further. So, if a risk of losing their money appears, they will do as much as they can to prevent it. The biggest, and one of the first companies involved is a pharmaceutical company called Novartis. Novartis is a Switzerland-based healthcare and wellbeing company that is now located all over the world.
During their first clinical trial of T-cell immunotherapy, or CART therapy, there was an average 60% response rate in previously non-responsive lymphomas. (Novartis) Now, this may not seem like very much, but we are talking about lymphomas that had been treated before and had a 3-0% response rate. That’s a 57-60% improval, which is a really big deal! There is still no screening test for lymphoma, so this cancer is often detected at a later stage, which is why it’s so important to have dependable treatments for unresponsive lymphomas. What needs to be focused on right now is, like I said earlier, safety, so that this treatment can be used without the dangers of CRS and other serious immune responses. Luckily, some treatments for CRS can be given at the same time as ctl019.
It’s actually a very easy treatment, which is nice for the patient. All that’s needed is an IV with an antihistamine, like chlorpheniramine, and a corticosteroid, like hydrocortisone, before starting the infusion of the modified cells back into the patient. Further doses can be given during the treatment if it’s needed. Then, if the doctors are worried about a fever, the patient can take acetaminophen by mouth before the treatment. This treatment, combined with the necessary safety procedures, could be the next breakthrough in treating blood cancers, and scientists are even looking into using this treatment for hard-tumor cancers, such as breast cancer and lung cancer.
It’s important to be conscious about these things, because you never know who could be diagnosed with a harmful and possibly deadly cancer. It could be your mom, an uncle, a friend, or a sibling. Knowledge is power. With that power, we can stop the second leading cause of the death in the United States, and save more than half a million lives every year. So stay informed, and help spread the knowledge to save lives, because not all that have it have the ability to share it. Works Cited “Current Concepts in the Diagnosis and Management of Cytokine Release Syndrome.
” Blood Journal. American Society of Hematology. Web. 02 Jan. 2017. “Lymphoma – Non-Hodgkin: Risk Factors.
” Cancer. ASCO University, 17 Dec. 2014. Web. 03 Jan.
2017. “Facts and Statistics-LLS.” Facts And Statistics. LLS. Web. 03 Jan.
2017. “NHL Statistics.” NHL Statistics. Web. 03 Jan. 2017.
“Types of Treatment for Non Hodgkin Lymphoma.” Cancer Research UK. Cancer Research UK. Web. 02 Jan.
2017. “Novartis Announces New CTL019 Study Data Demonstrating Overall Response in Adult Patients with Certain Types of Lymphoma.” Novartis. Novartis. Web.
03 Jan. 2017.
