Source: Mesothelioma
Guest Piece written by David Haas
David Haas is a health advocate specializing in mesothelioma. He works to ensure the continuation of awareness about the disease and supports active research being conducted to find a cure.
The American Cancer Society estimates that almost 2 million people will be diagnosed with cancer in the United States this year. Oncologists and researchers are working to develop new treatment options in hopes of increasing both the duration and quality of life of people with cancer. One relatively new treatment (CAR T-cell therapy) extracts and modifies T cells from the blood (type of immune cell), gives them a receptor that directs them to the specific type of cancer (Chimeric Antigen Receptor, or CAR) the patient has, and then places them back into the bloodstream. Patients are monitored closely because reintroduction of a large number of T cells can lead to life threatening complications. One possible complication is Cytokine Release Syndrome (CRS): the release of an excess of cytokines (an inflammatory molecule). CRS can cause a steep drop in blood pressure, high fever, and swelling of the brain, which can be fatal. These risks do not deter many patients who have limited treatment options left.
Given the success of CAR T-cell therapy for liquid tumors such as acute lymphoblastic leukemia (ALL; 83 percent remission rate in some clinical trials) there is discussion of how this treatment could impact solid tumors. However, site-specific drug delivery is more difficult for solid cancers.
The National Cancer Institute recently granted 11 million dollars to the University of Pennsylvania’s Abramson Cancer Center to study T cell therapy for solid tumors. This research will focus on a rare lung cancer known as malignant pleural mesothelioma (MPM), which has a notoriously poor prognosis. For people with late-stage mesothelioma, it’s unusual to live more than two years after diagnosis. If successful, research interest in CAR T-cell therapy for rare solid tumors may expand.
At Memorial Sloan Kettering Cancer Center (MSK) researchers have enrolled 12 people with MPM in a clinical trial of CAR-T-cell therapy. The early results are promising, showing no signs of toxicity, with one patient remaining clinically well eight months after T cell infusion.
It may be a while before this treatment is widely available, as one hurdle is price. The two FDA approved T cell treatments cost more than $370,000. This price would leave the average cancer patient in a debilitating amount of debt even with optimal insurance coverage. Regulators are looking to have these prices reduced.
While research may establish CAR T-cell therapy as effective for solid tumor cancers such as mesothelioma, the timeframe for accessible treatment may be several more years since it is experimental and prohibitively expensive.
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Sources
https://my.clevelandclinic.org/health/treatments/17726-car-t-cell-therapy/risks–benefits
https://labiotech.eu/features/car-t-therapy-cancer-review/