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Is this the start of the end for cancer?

September 2017

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Is this the breakthrough we have been waiting for? Certainly this week’s announcement of the approval of a form of gene therapy that fights individual cancers is being hailed as an “historic” moment.

The treatment involves a new “living” drug that is totally personalised to help adjust the immune system of the patient so that it starts vigorously attacking and destroying the cancer concerned.

This is a step forward from other gene therapies being looked at because it doesn’t try and replace the cancer causing genes with healthy ones. Instead, white blood cells (called T cells) are extracted from the patient. These are then sent off to a specialised laboratory where their DNA  are altered to include a specific gene that will direct the T cells to starting targeting the cancer cells.

This is highly complex technology, but once the T cells have been reprogrammed, they are copied millions of times before being infused back into the patient where they track down the cancer cells and start to destroy them.

T cells are a very important part of our immune system, and by reprogramming them they continue to do their job naturally but in a precisely directed way.

There are already some drugs that open up our immune system so that it will attack cancer cells, but this development is a major step forward, adjusting the immune system to target the specific cancer cells causing a specific cancer.

The engineered cells are called chimeric antigen receptor T cells, and so the new therapy is now being abbreviated to CAR T-cell therapy.

At the moment this new cancer treatment has been approved by the American Food and Drug Administration for use in children with an aggressive form of leukaemia. In clinical trials of 88 young patients who were suffering from a recurring or treatment resistant form of acute lymphoblastic leukaemia, 73 have gone into remission after being treatment with this new therapy.

The approval for the treatment has been described as a milestone by many top cancer specialists. Dr Crystal Mackall, associate director of Stanford University’s Cancer Institute, says the new treatment represents an entirely new class of cancer therapy that holds promise for all cancer patients. Dr David Maloney, the medical director of cellular immunotherapy at a major cancer research centre in Seattle, America, says he thinks this is just the first of what will soon be many new immunotherapy based treatments for a variety of cancers.

Currently, the cells are being modified at the American based manufacturing facility of Novartis, a global healthcare company based in Switzerland that has been involved in the development of the new treatment. The company has called the new treatment Kymriah and say they are hoping to have over 30 certificated treatment centres up and running by the end of 2018. This will be for patients under the age of 25s suffering from a specific type of cancer.

However, the next step is to adapt the therapy for patients with other types of cancers, and the next few years could see developments that, as Scott Gottlieb, a Commission of the American Food and Drug Administration puts it, “will change the face of modern medicine.”

There is a quick word of warning on all this though, the treatment can cause serious side effects including high fevers, a drop in blood pressure and some neurological problems, so despite the fact that it is already saving lives, there is a little way to go yet.

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