A "living drug" that could change the way we treat cancer | Carl June

TL;DR

This is the story of CAR T-cell therapy, a groundbreaking treatment for cancer that came after decades of research and has the potential to cure patients.

Transcript

So this is the first time I've told this story in public, the personal aspects of it. Yogi Berra was a world-famous baseball player who said, "If you come to a fork in the road, take it." Researchers had been, for more than a century, studying the immune system as a way to fight cancer, and cancer vaccines have, unfortunately, been disappointing. T... Read More

Key Insights

• 🧬 Cancer vaccines have been disappointing in fighting cancer, but synthetic immune systems, called CAR T cells, have shown promise in recognizing and killing cancer cells.
• 🏥 CAR T cells are the first living drug in medicine and have a calculated half-life of more than 17 years, providing long-lasting treatment for cancer patients.
• 🔬 The only source of T cells that work in a patient are their own T cells, making personalized CAR T cell therapy necessary.
• 👶 CAR T cell therapy has shown remarkable results in children with acute leukemia, with a 90% complete remission rate in the first 30 patients treated.
• 💊 The financial cost of CAR T cell therapy is high, but the cost of failure is even worse, as current non-curative therapies are also expensive and ineffective. ⏰ The development of CAR T cell therapy required persistence, vision, and patience, as it took 30 years of research and setbacks to reach its current success.
• 💪 The immune system's ability to eradicate leukemia is linked to cytokine release syndrome (CRS), with patients hoping for high fevers as a sign of the therapy's effectiveness.
• 💡 Scientists must continue research to make CAR T cell therapy more efficient and affordable for all patients, as it is a rapidly advancing field with the potential to revolutionize cancer treatment.

Questions & Answers

Q: What is the traditional approach to fighting cancer using the immune system?

Cancer vaccines have been a disappointing approach, as they have only worked in cancers caused by viruses. Cancer researchers gave up on using the immune system to fight cancer because it doesn't naturally recognize cancer as a problem.

Q: How did researchers overcome the immune system's limitations in fighting cancer?

Researchers developed synthetic immune systems using genetic engineering and synthetic biology. They combined the functions of B cells, which produce antibodies to kill bacteria, and T cells, which kill cells infected with viruses, to create CAR T cells designed to recognize and kill cancer cells.

Q: How were CAR T cells introduced into the patient's body?

CAR T cells were made using the patient's own T cells, as they are the only T cells that will work in a patient. Researchers learned to grow the patient's own T cells and used an HIV virus as a Trojan horse to get past the immune system of the T cells. The genes for antibodies from B cells were inserted into the T cells.

Q: How do CAR T cells work in attacking and killing cancer?

When CAR T cells are injected into someone with cancer, they recognize and bind to their tumor target. They act like supercharged killer T cells and start multiplying by the millions. CAR T cells stay alive and on the job for years, attacking and killing the tumor cells in the body.

Q: How effective are CAR T cells in treating cancer?

CAR T cells have shown remarkable results in clinical trials. In patients with leukemia, 90% of them had a complete remission within a month of receiving CAR T-cell therapy. Some patients have experienced long remissions that may be considered a cure. However, the financial cost of CAR T-cell therapy is a concern and efforts are being made to make it more affordable.

Summary & Key Takeaways

• Cancer vaccines have been disappointing in the past, but researchers have developed synthetic immune systems called CAR T cells that can recognize and kill cancer cells.

• CAR T cells have the ability to stay alive in the body for years and can effectively target and kill tumor cells.

• CAR T cell therapy has shown remarkable success in treating leukemia and lymphoma, with high remission rates and the potential for long-term cure. However, the high cost of CAR T cell therapy is a concern that needs to be addressed.