Thu, Jun 15, 2017 - Page 9 News List

The new frontier in cancer care: Turning blood into living drugs

Re-engineering patients’ immune cells to fight cancer is providing hope for a cure, as long as side effects and other issues can be reined in

By Lauran Neergaard  /  AP, SEATTLE

Illustration: Mountain People

Ken Shefveland’s body was swollen with cancer, treatment after treatment failing until doctors gambled on a radical approach: They removed some of his immune cells, engineered them into cancer assassins and unleashed them into his bloodstream.

Immune therapy is the hottest trend in cancer care and this is its next frontier — creating “living drugs” that grow inside the body into an army that seeks and destroys tumors.

Looking in the mirror, Shefveland saw “the cancer was just melting away.”

A month later, doctors at the Fred Hutchinson Cancer Research Center could not find any signs of lymphoma in the Vancouver, Washington, man’s body.

“Today I find out I’m in full remission — how wonderful is that?” Shefveland said with a wide grin, giving his physician a quick embrace.

This experimental therapy marks an entirely new way to treat cancer said if scientists can make it work, safely. Early-stage studies are stirring hope, as one-time infusions of supercharged immune cells help a remarkable number of patients with intractable leukemia or lymphoma.

“It shows the unbelievable power of your immune system,” said David Maloney, Fred Hutchinson medical director for cellular immunotherapy, who treated Shefveland with a type called chimeric antibody receptor (CAR) T cells.

“We’re talking, really, patients who have no other options, and we’re seeing tumors and leukemias disappear over weeks,” Fred Hutchinson immunotherapy scientific director Stanley Riddell said, but added: “There’s still lots to learn.”


T cells are key immune system soldiers, but cancer can be hard for them to spot and can put the brakes on an immune attack. Today’s popular immunotherapy drugs called “checkpoint inhibitors” release one brake so nearby T cells can strike.

The new cellular immunotherapy approach aims to be more potent: Give patients stronger T cells to begin with.

Currently available only in studies at major cancer centers, the first CAR-T cell therapies for a few blood cancers could hit the market later this year.

The US Food and Drug Administration (FDA) is evaluating one version developed by the University of Pennsylvania and licensed to Novartis and another created by the US National Cancer Institute (NCI) and licensed to Kite Pharma.

CAR-T therapy “feels very much like it’s ready for prime time” for advanced blood cancers, said Nick Haining, of the Dana-Farber Cancer Institute and the Eli and Edythe L. Broad Institute of MIT and Harvard, who is not involved in the development.

Now scientists are tackling a tougher next step, what Haining calls “the acid test”: Making T cells target far more common cancers — solid tumors like lung, breast or brain cancer. Cancer kills about 600,000 Americans per year, including nearly 45,000 from leukemia and lymphoma.

“There’s a desperate need,” NCI immunotherapy pioneer Steven Rosenberg said, pointing to requests from hundreds of patients for studies that accept only a few.

For all the excitement, there are formidable challenges.

Scientists are still unraveling why these living cancer drugs work for some people and not others. Doctors must learn to manage potentially life-threatening side effects from an overstimulated immune system.

Also concerning is a small number of deaths from brain swelling, an unexplained complication that forced another company, Juno Therapeutics, to halt development of one CAR-T in its pipeline; Kite recently reported a death, too.

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