Maybe it is because I have grown up constantly surrounded by sickness, or because I just generally have a fear of things I can’t control, but when I think of Cancer, when I hear the words “hospital” or “disease”, a pit grows in my stomach. If I hear my mom cough, or my dad say he has a headache, I get this irrational fear that something is horribly wrong. Even though the sensible part of me knows it is silly, I still worry. Your entire reality could change in the blink of an eye. And it’s not just me. I think throughout history we have presented Cancer as a scary, deadly, taboo topic. Although it is quite a scary thing to think about, in the midst of all of my fears, I think I often fail to realize just how hard scientists are working to provide solutions. Clinical trials, discoveries, and new therapies are being presented every day. While the fear may never fully go away, focusing on some of the positive breakthroughs, instead of simply the scariness of it all, I aim to provide some readers with hope, and if not hope, maybe some peace of mind for a better future.
Cellular therapy is a cancer treatment that has only recently come into the picture but is groundbreaking for not only treating cancer but many other diseases. In this article, we will mainly be focusing on cellular therapy treatments for cancer. This treatment is a stepping stone to the more modern medicines of the future, and we are only scratching the surface of its true capabilities. Not only will cellular therapy change the future for cancer patients, but it also offers cures for many other diseases. These include spinal cord injuries, type 1 diabetes, Parkinson’s disease, amyotrophic lateral sclerosis, Alzheimer’s disease, heart disease, strokes, burns and osteoarthritis.
Most commonly known as “cellular therapy”, this treatment is also called adoptive cell therapy and cellular immunotherapy. Its intent is to help your body fight off diseases and infections. There are several different types of cellular therapy, and many are still being developed and are not yet implemented in treatment plans. According to the National Cancer Institute, the process of Cellular Therapy starts with immune cells. Inside our body are immune cells, which keep us from getting sick and fight off infections. Some of the strongest immune cells in our body are T-cells, also known as white blood cells, and they come in several different types. Their job is to target and eliminate cancer cells, as well as bacterial infections and cells infected by viruses. However, often these cells alone are not enough to stop the cancer from taking over. This could be from lack in numbers, or not being able to maintain activity long enough for an efficient anti-tumor response. Through the process of cellular therapy, scientists are able to directly isolate immune cells from your body and expand their numbers, or genetically engineer these immune cells (via gene therapy) to enhance their cancer-fighting capabilities in order to effectively eradicate the cancer.
Now that we have a general sense of what cellular therapy is, it’s important to know there are many different types and treatments that use these methods. The most common treatment of cellular therapy is called CAR-T therapy. With this method, T cells are taken from the patient’s body. These cells are then grown in a lab, and genetically modified to produce proteins called CARs (Chimeric Antigen Receptors). The CAR proteins form on the cell surface and allow the T cells to identify proteins in cancer cells, to target and eliminate them. The genetically modified immune cells are then placed back into the patient’s body and are monitored to see if they are doing their job in fighting the cancer.
As these therapies become more common new types are being invented. These include non-genetically modified therapies but still fall under the umbrella of cellular therapy. Some examples of this are T-IL therapy (Tumor-Infiltrating Lymphocyte therapy), NK cell therapy (Natural Killer), and cell manipulation. These treatments focus on extracting T cells from the tissue of the tumor in your body, as well as exposing immune cells to different substances in your body, that will allow the cells to become able to identify the disease and fight it off. These therapies are continuously being improved and worked on, with even the possibility of new therapies in the coming years.
This type of treatment is relatively new compared to others that have been used since the late 1900’s. Each new method must undergo vigorous testing in order to be approved. Additional information provided by expert Dr. Mignon Loh, the leader of Cancer and Blood research at the Seattle Children’s Hospital, takes us further into how these trials work. Dr. Loh shares “It can take years to develop a drug because you have to first synthesize it, then see if it works in cell lines that model the cancer you are studying, then in mouse models that also reflect the cancer you are studying, and then you can test in humans. Generally, it takes a decade or more before the treatment can be used effectively.” She goes on to explain “There are lots of steps to getting a new therapy approved with many clinical trials that first find the right dose, then testing that dose in specific tumors to see if it is effective, and then testing that new medicine against the standard medicine to see if it is better.” Clearly, the development of these treatments can be time-consuming and expensive, but it is well worth the struggle to see such positive results.
The goal is to spread these treatments across the world so that they can be implemented in many communities. According to DDW (Drug Discovery World), as of 2021, Europe had 230 developers of cellular & gene therapies and had raised over €3.3 billion in funding. Countries including the US, Finland, and the UK have started clinical trials for these treatments. CAR-T cell therapy is being applied here in Barcelona, at The Sant Joan de Déu Barcelona Hospital. An expert in this field, and doctor at SJD, Dr. Susana Rives, the head of the Haematopoietic System Tumors Functional Unit of the Oncology Department, shares her insights about implementing CAR-T cell therapy. Rives explains, “Our goal is to ensure that patients with Leukemia have access to immunotherapy treatments from the outset, not only in the event of a relapse” Dr. Rives stresses the importance of the use of CAR-T cell therapy to all patients, and shares that 80% of patients treated have gone into remission after the first 3 months of use of CAR-T therapy. This is a huge improvement compared to previous treatments, which used to take up to 3 years to be effective. Because these treatments are so new, clearly not all the kinks are worked out yet. However, these incredible breakthroughs show the true potential of cellular therapy.
Overall, there have been noticeable data changes since implementing cellular therapy around the world. Despite its potential, cellular therapy is not widely used because it poses a new approach to cures for disease, and is just beginning to be explored. Data provided by the WWD shows the number of active cell therapies has increased from 200 to over 3,000. Within these results, cancer still poses one of the leading causes of death around the world, with over 10 million people dying of cancer every year. That being said, since the invention of cellular therapy in 1987, the annual number of deaths due to cancer has decreased by 15%. The timing of these two events is hard not to notice. Although these aren’t spectacular results, there have been improvements, and, as research continues to develop, the deaths will continue to decrease.
This may seem like the perfect solution, right? All sickness gone forever, perfect health and prosperity for all. However, there are some negative side effects to using these treatments. The most prominent is the process of getting the cells in and out of the patient’s body. With time scientists have developed strategies to decrease the risk factors, however, there are still instances where the modified cells do not work. Not because of their design, but because of immunosuppressive TME and poor infiltration and persistence. Surrounding cancer tumors in the body are non-cancerous cells that serve as a barrier. This barrier can be hard for the engineered cells to infiltrate. Thankfully, scientists are looking for and discovering ways to get around this, but it still poses a problem. Another concern when using cellular therapies is the difficulty of transport, making it more challenging to spread globally. Given this issue, the stock of these immune cells can vary, making them difficult to access. This greatly increases the price, making the majority of cellular therapies relatively expensive. Currently, companies are working on the exportation of these cells. The more common they become, the more available they will be to patients. It is simply an issue of how new they are, but with time these problems will be solved.
Cellular therapy is becoming increasingly popular, however, there are many other treatments already in use for treating cancer. In an article from the National Cancer Institute, it is noted that there are ten other treatments currently being used. Some treatments kill the cancer cells with radiation or heat, while others utilize chemicals (chemotherapy) to kill or stop the growth of the tumor. These methods are effective, however they can leave lasting effects on the body. Chemotherapy kills the cancer cells, but in the process can also kill immune cells which you need to keep your body healthy. This leaves cancer survivors with weakened immune systems, making it easier for them to get sick, and common illnesses become more deadly. Dr. Loh, when asked about the development of chemotherapy treatments stated “I think that new medicines [for leukemia] will move beyond general drugs that have a lot of side effects and get more specific for the cancer [leukemia] cells.” Another common treatment with significant side effects is Radiation. Radiation is often used for the early cancer stages to shrink the tumor and stop the spread of cancer cells. However, radiation can damage non-cancerous cells and impair the function of tissues. High levels of radiation can cause an increased risk of skin cancer later in life. As seen from these different treatments, they can leave lasting effects. Cellular therapy offers an efficient and safe method for treating cancer and has fewer negative side effects.
It is truly incredible the things we can do with these modern cellular technologies. As these treatments continue to develop we will not need to be as afraid of cancer and other previously life-threatening diseases. Cellular therapy offers a glimpse of the future of medicine. According to Forbes News, the US FDA (United States Food & Drug Administration) anticipates the approval of 10 to 20 more therapies by the end of the year 2025 (Data taken in 2022). There are a vast number of possible treatments and they have the potential to change the way sickness is perceived, forever. As treatments like cellular therapy become more and more common, the unease sickness provokes will decrease. As new treatments continue to develop, we strive for a world where sickness is no longer a source of concern.
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