Cellular therapies use cells, rather than chemical compounds or molecules, to fight cancer. Some are made by genetically modifying specific cells from a patient or donor to improve the cells' cancer-tracking and cancer-attacking ability; others do not
involve such modifications.
Genetically Modified Therapies
CAR T-Cell Therapies
Chimeric antigen receptor (CAR) T-cell therapy has been approved as standard of care for some types of blood cancers.
A new generation of CAR T-cell therapies, potentially better able to identify tumor cells and overcome tumors' evasive moves, is now in clinical testing. Trials of these therapies are also underway
in patients with non-hematological malignancies such as prostate, breast, stomach and rectal cancers, among others.
Scientists are also exploring ways to make CAR T-cell therapies more effective as well as reduce the side effects of therapy.
- Combining CAR T with other therapies: Studies are exploring ways to improve the effect of CAR T cells by combining them with other immunotherapies such as checkpoint inhibitors or NK cells. In addition, teams are using CAR T either
before or after stem cell transplant to optimize outcomes.
- Minimizing side effects: In one study, investigators are testing CAR T cells that target “checkpoint” proteins on tumor cells in combination with defibrotide, a drug that prevents blood clots, or the immunosuppressive drug anakinra.
Other studies are exploring the potential of new agents like siltuximab. Researchers are also testing alternate dosing and treatment schedules for standard medicines for CAR T cell-related side effects in an effort to find the optimal approach.
- Timing of CAR T-cell therapy: Currently, CAR T-cell therapies are approved for patients who have relapsed after initial treatment. Studies are underway looking into whether CAR T-cell therapy is most effective as an early-stage or
- Allogeneic CAR T: Current, approved CAR T products use a patient's own T cells and re-engineer them to target cancer cells. The manufacturing time can take 2-3 weeks. Trials are exploring using donor-matched, or allogeneic CAR T cells
that could be pre-manufactured and ready, off the shelf for patients in need.
- Correlative research: Scientists are conducting "correlative" studies to determine how well CAR T cells make their way to tumor tissue and how effectively they function once there.
Engineered T Cell Receptor (TCR) Therapy
Engineered T cell receptor (TCR) therapy works by genetically modifying T cells to produce a new receptor that enables them to latch onto specific target proteins on tumor cells. This enables TCR T cells to specifically target cancer cells and avoid normal
cells, sparing patients some of the side effects associated with CAR T-cell therapy. Also, unlike CAR T cells, which take aim at antigen proteins on the tumor cell surface, TCR therapy targets antigens within the tumor cell, which are activated only
when a cell is cancerous. This, too, can reduce side effects. Engineered TCR therapy is currently in clinical trials for patients with melanoma, sarcoma, and head and neck cancer.
Non-Genetically Modified Therapies
Tumor Infiltrating Lymphocyte (T-IL) Therapy
This approach involves collecting a sample of tumor tissue and extracting the T cells within it. The cells are allowed to multiply in a lab, then reinfused into the patient. TIL therapy has shown effectiveness for some patients with melanoma and trials are underway in several solid tumors such as cervical and lung cancer.
NK Cell Therapy
NK cells are part of the immune system first line of defense against infection and disease. While they can detect and destroy infected and malignant cells directly, without having to be activated or “trained” to respond to them, it is now understood that
NK cells perform better when they are activated by exposure to immune system substances called cytokines. Our program offers clinical trials of NK-cell therapy for patients with myelodysplastic
syndrome, acute myeloid leukemia, and head and neck cancer.
Cell Manipulation Core Facility
For some cellular therapy products – especially in early phase clinical trials – our on-site Connell and O'Reilly Families Cell Manipulation Core Facility (CMCF) performs the primary cell manufacturing of genetically engineered products. For other cellular therapy products, cells are primarily manufactured at an outside commercial facility and the CMCF oversees the process of collecting the cells, shipment to the offsite commercial facility, return of the processed cells, and release for patient treatment.