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By Dr. Rayaz Ahmed in Cancer Care / Oncology , Bone Marrow Transplant , Haematology , Hematology Oncology
Jun 05 , 2024 | 2 min read
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The emergence of CAR T cell therapy as a major advance in cancer treatment provides hope where traditional treatments have fallen short. CAR T therapy, short for Chimeric Antigen Receptor T-cell therapy, represents a cutting-edge approach that harnesses the power of the immune system to combat cancer. In some types of blood cancer, this innovative treatment has shown remarkable efficacy, which is a major achievement in the fight against this disease.
At its core, CAR T therapy involves reprogramming a patient's immune cells, specifically T cells, to recognize and attack cancer cells. This process begins by extracting T cells from the patient's blood, which are then genetically engineered to express chimeric antigen receptors (CARs) on their surface. These CARs are designed to target specific proteins, or antigens, present on the surface of cancer cells.
Once the T cells have been modified, they are multiplied in the laboratory to create a large population of CAR T cells. The engineered cells are then injected back into the patient, where they seek and destroy cancer cells that harbour the targeted antigen. The result is a highly targeted and potent immune response against the cancer, with the potential for long-lasting remission.
The success of CAR T therapy has been most prominently demonstrated in the treatment of certain types of blood cancers, particularly B-cell malignancies such as acute lymphoblastic leukaemia (ALL) and non-Hodgkin lymphoma (NHL). Clinical trials have shown unprecedented response rates in patients who have failed conventional treatments, leading to approvals by regulatory agencies such as the FDA and EMA.
The ability to induce durable remission in patients with advanced disease who have exhausted all other treatment options is one of the key advantages of CART therapy. In some cases, patients have achieved complete responses, with no evidence of disease remaining after treatment. This represents a paradigm shift in cancer care, giving hope to patients who previously had few options for effective treatment.
However, despite its remarkable efficacy, CAR T therapy has challenges. One of the most significant obstacles is the potential for severe side effects, known as cytokine release syndrome (CRS) and neurotoxicity. CRS occurs when the infused CAR T cells activate and release large amounts of cytokines, triggering systemic inflammation that can lead to fever, low blood pressure, and organ dysfunction. Neurotoxicity, on the other hand, manifests as confusion, seizures, and other neurological symptoms.
To mitigate these risks, researchers are actively exploring ways to optimise CAR T cell therapy, including the development of novel CAR designs, the use of combination therapies, and the implementation of patient monitoring strategies. In addition, the efficacy of CAR T therapy in different types of cancer is being studied in ongoing clinical studies, expanding the potential applications of this groundbreaking treatment approach.
In conclusion, CAR T therapy represents a transformative approach to cancer treatment, offering new hope to patients with advanced disease. While challenges remain, the remarkable success of CAR T therapy in certain blood cancers underscores its potential to revolutionise cancer care. With continued research and innovation, CAR T therapy promises to improve outcomes for patients across a wide range of cancer types, ushering in a new era of personalised and targeted cancer therapy.
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