Dr Su W Maung
Consultant Haematologist, Mater Misericordiae University Hospital, Dublin. Secretary/Treasurer, Haematology Association of Ireland
Eva Szegezdi
Associate Professor in Biochemistry, Director, Blood Cancer Network Ireland,
Co-ordinator, INTEGRATE Doctorate Programme in Integrative Genomics,
University of Galway, Ireland
Experts say that ongoing trials surrounding CAR-T and NK cell immunotherapies have the potential to revolutionise cancer care.
Chimeric antigen receptor T-cell (CAR-T) therapy is a form of cellular immunotherapy known as adoptive cell transfer, targeting tumour-associated antigens in cancer cells. CAR-T cells are typically developed to recognise and attack a patient’s harmful cancer cells. Like CAR-T, natural killer (NK) therapy is a type of cellular immunotherapy. Unlike CAR-T, in addition to a specific antigen, CAR-NK cells can also identify cancerous cells via a range of N-activating receptors.
CAR-T extending lives of cancer patients
Dr Su Maung, consultant haematologist at the Mater Misericordiae University Hospital and current Secretary/Treasurer at Haematology Association of Ireland, says CAR-T is proving successful in clinical trials.
“In Ireland, we have approved CAR-T cell therapies for certain subtypes of B cell lymphoma and leukaemia. Clinical trials has an overall response rate up to 82%, which is extraordinary. This includes patients who have a complete response — meaning, they are still alive and well, thanks to their treatments.
“We believe the very high response rates are due to the fact patients are receiving a living drug that is proactively finding harmful cells and killing them.” However, Dr Maung believes there are still limitations in delivery of service, which must be expedited for patients to better access treatment.
“We would also like to be able to better manage the effects of CAR-T treatment which includes toxicity and infections.”
The drugs currently used for blood cancers have
Eva Szegezdi
serious side effects as they also kill healthy cells.
More adaptable ‘live’ treatment option
Meanwhile, similar to CAR-T cells, NK cells act as ‘living drugs,’ and they can be from any donor. They are then genetically engineered and processed for cancer treatment.
Eva Szegezdi, Director of Blood Cancer Network Ireland (BCNI) at the University of Galway, explains: “The drugs currently used for blood cancers have serious side effects as they also kill healthy cells. These drugs also get eliminated from the body very quickly. Whereas, live immune cells are adaptable and can persist for a long time.”
Genetic engineering by BCNI is focused on generating therapeutic CAR-NK cells, which can eliminate cancerous cells and without affecting healthy ones. “Currently, we test these NK cells on biobanked patient samples. When we progress further, we will engage in clinical trials.” She expects the first trial in Ireland to be with 20 or 30 patients. “If that is successful, it will probably become an international trial.”
Potential for improved cancer treatments
With these findings and trials ongoing, patients in Ireland could potentially have access to more targeted treatment options, alongside traditional chemotherapy treatment.