CAR-T cell therapy – a new era in cancer treatment
Dr Reuben Benjamin, Consultant Haematologist at King's College Hospital NHS Foundation Trust, blogs about a how a new immunotherapy is set to transform care for blood cancer patients.
An important milestone in the field of cancer therapy was reached last month after the first two chimeric antigen receptor T cell (CAR-T cell) medicines were recommended for approval by the European Medicines Agency. The two medicines: Kymriah and Yescarta CAR-T cell therapies can now be used to treat two of the most debilitating blood cancers – B-cell acute lymphoblastic leukaemia and high-grade B-cell lymphoma.
What is CAR-T cell therapy?
CAR-T cells are a novel form of immunotherapy where immune cells (T cells) are collected from patients and genetically modified to destroy cancer cells. These tumour targeted CAR-T cells are grown in the laboratory for two to three weeks before being infused back into the patient after some low dose chemotherapy. Results from early clinical trials with CAR-T cells targeted against CD19, a protein strongly expressed by many blood cancers, have shown highly impressive outcomes in patients with relapsed disease who have no other treatment options, leading to the eventual licensing of these two products.
Kings Health Partners have been at the forefront of this technology with a number of first in human CAR-T cell trials currently being conducted in blood cancers and solid organ tumours at King’s College Hospital and Guy’s and St Thomas’ NHS Foundation Trusts. Many of the viral vectors (tools used to deliver genetic material into cells) used to generate CAR-T cells for clinical trials worldwide are manufactured at the Rayne Institute, King’s College London. A significant amount of scientific research is taking place across our partnership to find ways to further improve the effectiveness of this novel therapy and to develop the next generation of CAR-T cell products.
Pioneering off the shelf treatment
At King’s College Hospital NHS Foundation Trust we have been pioneering a new form of CAR-T cell known as ‘off the shelf’ or universal CAR-T cells. The advantage of these universal CAR-T cells is that they are premade from immune cells derived from normal donors rather than patients, and so in theory are readily available to be infused into a patient when needed. These universal CAR-T cells have been further modified using gene editing technology called transcription activator-like effector nucleases (TALENs) to remove their own T cell receptor thereby allowing the cells to be given to any patient without the need for any tissue matching. If these universal CAR-T cells can be shown to be effective and safe,
this will represent a significant advance in the field of
cancer treatment, including blood cancer treatments.
With the recent approval of two CAR-T cell products we will now embark on a significant expansion of our CAR-T cell programme treating patients from across the UK and abroad with a wide range of blood cancers including acute myeloid leukaemia, acute lymphoblastic leukaemia, lymphoma and myeloma. This truly represents the dawn of a new era in cancer treatment.
The King’s Health Partners Haematology Institute is aiming to bring together our strengths in clinical service, research, and education to deliver exceptional outcomes for haematology patients. Our vision is to develop cures and vaccinations for haematological conditions so that future generations do not have to face lives with these diseases.