While surgery, chemotherapy and radiation therapy have been the basis of cancer treatment for decades, a new type of treatment could be the next core pillar in oncology. Immunotherapy, which stimulates the body’s own immune system to destroy cancer cells, has already been successful when used to treat some blood cancers, and researchers believe it could someday be effective for people with solid tumors like breast, prostate or colorectal cancer.1
“This is very important for the future of oncology treatments,” said Parameswaran Hari, MD, hematologist/oncologist and Chief of the Division of Hematology and Oncology at the Froedtert & the Medical College of Wisconsin Clinical Cancer Center. “This type of cellular immunotherapy technology is already in clinical trials for a wide variety of cancers. If it is successful, it could become a broad alternative to chemotherapy, or be used in addition to or even in combination with chemotherapy.”
Just over a year ago, an Appleton man became the first person to receive a type of chimeric antigen receptor (CAR) T-cell therapy in a clinical trial that targets two molecules on a cancer cell’s surface, rather than one. Bret C. had mantle cell lymphoma, a type of cancer that affects white blood cells that are part of the immune system. His oncologists at the Froedtert & MCW Clinical Cancer Center at Froedtert Hospital genetically engineered his immune cells to seek out and destroy the cancerous cells. Within weeks of the treatment, there were no signs of cancer. Bret’s prognosis and this type of immunotherapy show strong potential for people with lymphoma and many others.
“We are harnessing knowledge from decades of research to improve outcomes for patients,” said Nirav Shah, MD, hematologist/oncologist with the Froedtert & MCW Clinical Cancer Center. “There is amazing potential here for the future of cancer treatment, and a healthier world is closer than ever.”
The Froedtert & MCW Cancer Network is enrolling participants in a Phase II clinical trial for people with metastatic and/or recurrent head and neck cancer. The treatment uses tumor-infiltrating lymphocytes made up of specialized white blood cells — T-cells that are grown from a person’s tumor. T-cells are the body’s mechanism for eliminating abnormal cells, so they are the natural enemy of cancer.
“A sample of cells are extracted from a patient’s tumor and expanded and activated in a lab to produce a critical dose of tumor-infiltrating lymphocytes,” Dr. Hari said. “Then, patients are reinfused with their own cancer-fighting cells.”
Genetically re-engineered CAR T cells are able to recognize a specific protein on the surface of the cancer cells and destroy them.
1. Extract T cells from patient's tumor.
2. Genetically re-engineered T cells, expanded and activated in a lab, produce cancer-destroying cells.
3. Grow a critical dose of cancer-destroying cells.
4. Infuse cancer-destroying cells back into patient's body.
5. CAR T cells continue destroying cancer cells throughout patient's lifetime.
By using a person’s own cells, CAR T-cell therapy prevents the body from rejecting the cells, and the cells do not attack other tissues. Unlike chemotherapy, where the treatment duration is for a set time, CAR T-cell therapy also offers a persistent way of activating the body’s immune system so that it can keep fighting the cancer throughout a person’s lifetime.
Dr. Hari calls immunotherapy the most “organic” way to treat cancer.
“Many people don’t get cancer because their innate immune systems take care of abnormal cells before they become cancerous,” Dr. Hari said. “Right now, we are in the first wave of development of CAR T-cell immunotherapy, similar to where antibiotics were in the 1940s.”
Right now, patients throughout the Froedtert & MCW Cancer Network have access to several CAR T-cell therapy options for lymphoma, leukemia and myeloma. These options and others are approved by the Food and Drug Administration for clinical trials for lymphoma and myeloma. Axicabtagene ciloleucel (Yescarta®) is a CAR T-cell therapy for patients with aggressive B-cell lymphomas. Tisagenlecleucel (KYMRIAH®) is another CAR T-cell therapy option approved for adults with aggressive B-cell lymphomas and for pediatric and young adult patients with acute lymphoblastic leukemia.
To learn more about CAR T-cell therapy, visit: froedtert.com/car-t