A brief overview
In the ever-evolving field of immunotherapy, chimeric antigen receptor T-cell therapy, commonly known as CAR-T cell therapy, has emerged as a groundbreaking medical innovation. CAR T-cell therapy is a form of immunotherapy that harnesses the power of the body’s immune system to combat cancer. It involves the genetic modification of a patient’s own T cells, which are a type of white blood cell responsible for detecting and destroying foreign invaders, such as viruses and bacteria. The modification process equips these T cells with chimeric antigen receptors (CARs), engineered to recognize specific molecules on the surface of oncologic cells in the body.
In this article, we will explore the concept of CAR T cells, their history, mechanisms and types, overall costs, as well as the profound impact they have had on the landscape of cancer therapy.
History of CAR-T cell therapy
The roots of CAR-T cell therapy can be traced back to the early 1980s when scientists began exploring the idea of genetically modifying T cells to enhance their tumor-fighting capabilities. However, it wasn’t until the 21st century that significant breakthroughs were made, leading to the development of modern CAR-T cell therapy.
One of the key milestones was the discovery of CARs, which act as molecular sensors, recognizing cancer-specific antigens. CARs are composed of three main components: an extracellular domain that binds to the target antigen, a transmembrane domain that anchors the receptor in the cell membrane, and an intracellular domain responsible for activating the T cell upon antigen binding.
Mechanisms of action
CAR T cells are designed to target specific antigens on the surface of cancer cells, allowing for precise and targeted therapy. The growing prevalence of various types of cancer, especially different forms of lymphoma and leukemia, is expected to drive the expansion of the CAR T-cell therapy market in the coming years.
The globally approved CAR-T therapies up to this date include:
The approval of the first CAR T-cell therapy Kymriah in 2017 by the US Food and Drug Administration (FDA) marked a turning point for this therapy
• Kymriah®- Tisagenlecleucel (2017)
• Yescarta®- Axicabtagene ciloleucel (2017)
• Tecartus®- Brexucabtagene autoleucel (2020)
• Breyanzi®- Lisocabtagene maraleucel (2021)
• Abecma®- Idecabtagene vicleucel (2021)
• Carvykti®- Ciltacabtagene autoleucel (2022)
Cost and accessibility
The primary obstacles in making CAR-T cell therapy more accessible to a broader patient population revolve around affordability, large scale manufacturing requirements and availability. The treatment is prohibitively costly, and there are extended waiting periods for participation in clinical trials.BEST DOCTORS’ COMMITMENT TO BETTER HEALTH
- As of today, a patient undergoing Carvykti therapy has received approximately US$ 1,047,638 in paid benefits
- Another member has been allocated US$ 895,103 for funding his Yescarta treatment
These substantial sums represent the financial support provided to our members in need of these highly personalized and cutting-edge immunotherapies.
Clinical successes and challenges
CAR T-cell therapy has shown remarkable success in the treatment of hematologic malignancies such as acute lymphoblastic leukemia (ALL) and diffuse large B-cell lymphoma (DLBCL). Patients who had previously exhausted other treatment options have experienced remission and even long-term survival following CAR-T cell therapy.
As research in the field of immunotherapy continues to advance, scientists are actively working to address the limitations of CAR-T cell therapy. Efforts are being made to improve the safety profile, increase the effectiveness against solid tumors, and expand the range of treatable cancers. Combination therapies, using CAR-T cells in conjunction with other immunotherapies or traditional treatments, are also being explored to enhance the overall response rates.
Conclusion
CAR-T cell therapy is a transformative approach to cancer treatment that holds great promise for patients facing challenging and refractory cancers. With ongoing research and development, we can expect further advancements in the field of immunotherapy, ultimately leading to more effective and personalized cancer treatments. The innovative science behind CAR T cells exemplifies the remarkable progress that can be achieved when cutting-edge technologies and human ingenuity converge in the pursuit of improved healthcare.
Sources
- A Global Turning Point for Cancer CAR T-Cell Therapy. Market research. com. Feb. 2023
(https://blog.marketresearch.com/a-global-turning-point-for-cancer-car-t-cell-therapy) - Mayo clinic researchers expand CAR-T cell therapy options. December 2020
(https://www.mayo.edu/research/forefront/mayo-clinic-researchers-expand-car-t-cell-therapy-options)
