A decade of CAR-T cell therapy

Recommendable! A survey like article about CAR (chimeric antigen receptor)-T cell therapy. Cancer is history (soon)!

"... In 2017, Kymriah became the first gene therapy approved by the US Food and Drug Administration (FDA). It was first authorised as a drug-of-last-resort for treating ALL [acute lymphoblastic leukaemia] and then for treating another blood cancer, diffuse large B-cell lymphoma. Kymriah is now used as against both indications in many countries, including the UK. ...
Four others are now authorised for treating a variety of blood cancers – Yescarta and Tecartus marketed by Kite Pharma and Bristol-Myers Squibb’s Breyanzi and Abecma. Many other CAR-T cell therapies are in the pipeline with more than 600 clinical trials currently underway. Most are aimed at treating blood cancers, but CAR-T cell therapies are also being developed for solid cancers, HIV, autoimmune diseases and even heart attacks. Researchers are also developing cheaper and easier ways to deliver CAR-T cell therapies to those in need. ...

T cells are white blood cells with a vital role in our immune system. They host proteins called T cell receptors on their surface, and as the T cells circulate the body, these receptors recognise antigens on abnormal or infected cells. Then, depending on the type of T cells they are, they either destroy the damaged cells themselves or stimulate the other white blood cells around them to do so.

A chimeric antigen receptor is a genetically modified version of the T cell receptor that recognises specific antigens on a particular type of diseased cell. Most of the approved CAR-T cell therapies to date target CD19, a protein that is commonly found on the surface of malignant B cells. B cells are white blood cells that – when healthy – produce antibodies to help the body fight infection

The manufacturing process for all the approved therapies is the same. First, T cells are harvested from a patient’s blood by passing it through a machine that separates blood into its various components. The rest of the blood is then returned to the patient. The T cells are then sent to a centralised manufacturing facility where their genetic material is modified. A lentiviral or retroviral vector delivers the new genetic information to the T cell by attaching itself to the cell surface and injecting RNA into its cytoplasm. This genetic information is essentially the recipe needed to produce the CAR. The genetic recipe is then incorporated into the T cell’s genome, so the protein it codes for (the CAR) is synthesised and expressed on the surface of the T cell. The CAR-T cells are then multiplied, frozen and returned to the hospital for infusion back into the patient. The process typically takes several weeks. ..."

A decade of CAR-T cell therapy | Feature | Chemistry World The revolutionary treatment already taking on cancer, now aiming for wider use