A new CAR for T-Cells

You get a CAR! and you get a CAR, and you get a CAR!!

T-cell therapy has slowly emerged over the last decade or so as a novel immunotherapy for several forms of cancer, primarily blood cancers such as lymphoma. It involves taking T-cells from the patient, genetically modifying them with what’s called a chimeric antigen receptor or CAR, which binds specifically to the tumor cells of the patient, then placing them back into the patient with the idea that it would boost immune system recognition of the tumor, according to this article from a cancer news site. It seems simple enough. Give your t-cells a receptor that binds to your cancer, and the only change that should happen is it now has the ability to attack your tumor. Easy. This concept bridges fundamental immune system understanding with high level genetic engineering (maybe I’m just saying that because I have very little understanding of genetic engineering in the first place).

When you get into the logistics of it however, T-cell therapy goes big in all aspects of a cancer treatment. Not only is it seriously effective, but it also can have serious side effects and is seriously expensive. We’re talking nearly $500,000. Some of the side effects include severe cytokine responses, and several neurological problems such as speech problems and seizures. Not quite the miracle cure it sounded like it was before, but, they never are. Fortunately, the ever-moving flow of research promises methods of maintaining efficacy of the treatment while reducing rates of complications. According to this cancer.gov article, trials are underway testing new and different patterns for the CAR receptor to make it more specific to the tumor, with less of the unwanted reactions with other host cells.

This is all good and dandy, and maybe this is a lack of cancer treatment exposure on my part, but how did this treatment get through without dealing with these complications in the first place? Were researchers simply not equipped with the tools necessary to test for unwanted binding with other host cells? Were they acknowledged but deemed a much better outcome for the patient than likely death? Or is it a matter of the CAR being developed specifically for each person, and so it is difficult to predict an unwanted reaction, making it a risk associated with personalized medicine? These are difficult questions to answer, but hopefully ones that will become obsolete with the passing of time and research.