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Sheykhhasan, M., Manoochehri, H. & Dama, P. Use of CAR T-cell for acute lymphoblastic leukemia (ALL) treatment: a review study. Cancer Gene Ther 29, 1080–1096 (2022). https://doi.org/10.1038/s41417-021-00418-1
This research paper is a review study that examines the use of CAR T-cell (chimeric antigen receptor T-cell) therapy for the treatment of acute lymphoblastic leukemia (ALL). The study provides an overview of the current understanding of the biology of ALL and the mechanisms of action of CAR T-cells.
ALL is an aggressive blood cancer that is characterized by the change and increase in the number of malignant lymphoblasts (abnormal lymphocytes, which are white blood cells), which leads to the accumulation of cancer cells in the bone marrow and the blood. The standard treatment for ALL is chemotherapy, which can achieve remission in the majority of patients. However, some patients may relapse or become resistant to chemotherapy, and they have a poor prognosis.
CAR T-cell therapy is a new approach to treating ALL that uses the patient’s T-cells, which are white blood cells that can recognize and eliminate cancer cells. The T-cells are genetically modified in a lab to express a receptor known as the chimeric antigen receptor (CAR) on their surface, which enables them to recognize and bind to a specific protein on the surface of the cancer cells. Once the CAR T-cells bind to the cancer cells, they release cytotoxic molecules (substances that can kill cells) that kill the cancer cells.
Data from clinical trials have shown that CAR T-cell therapies are highly effective in treating relapsed or refractory (cancer that does not respond to treatment) ALL, resulting in high response rates and durable remissions. The study also found CAR T-cell therapy is acceptably safe, with side effects that are manageable and reversible. However, further research is needed to improve the safety and efficacy of this treatment approach.
Other benefits of the treatment are that a lower number of infusions are needed, it is a shorter treatment period, and recovery is faster. Furthermore, it is a highly specific therapy where cells with specific tumor-associated antigens can be removed, so unnecessary removal of healthy cells is avoided.
The study also discusses the need for new CAR designs and the identification of biomarkers that can predict the response to therapy. Current CAR designs target the CD19 protein, which is present on the surface of most B-cell (a type of white blood cell that is responsible for immunity) malignancies, including ALL. However, some patients do not respond to CAR T-cell therapy targeting CD19 and some patients relapse after the initial response. Therefore, new CAR designs that target other proteins on the cancer cells should be developed. Additionally, biomarkers that can predict the response to therapy should be identified to help select the patients most likely to benefit from CAR T-cell therapy.
Overall, the study concludes that CAR T-cell therapy is an effective treatment option for patients with relapsed or refractory ALL, having high response rates and durable remissions. However, it also highlights the need for further research to improve the safety and efficacy of this treatment approach, including the development of new CAR designs and the identification of biomarkers to predict response to therapy. This new treatment of lymphoblastic leukemia is an important development in cancer treatment and will grow to benefit the lives of many.
Works Cited
“CAR-T Cell Therapy: Using Healthy Cells to Fight Cancer – Abramson Cancer Center | Penn Medicine.” Penn Medicine – Abramson Cancer Center, http://www.pennmedicine.org/cancer/navigating-cancer-care/treatment-types/immunotherapy/what-is-car-t-therapy.
“NCI Dictionary of Cancer Terms.” National Cancer Institute, 2 Feb. 2011, http://www.cancer.gov/publications/dictionaries/cancer-terms/def/lymphoblast.
Summarised by Anoushka Shah
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