Genetically
modified T cells (white blood cells) have recently been shown to be extremely effective in treating certain forms of advanced cancer.
Genetically
modified T cells are one of two promising avenues the research team is pursuing in order to develop new treatments for cancer.
- Chimeric Antigen Receptor -
Modified T Cells for Acute Lymphoid Leukemia; Stephan A. Grupp MD, PhD, University of Pennsylvania Children's Hospital of Philadelphia.
A phase I / II trial of genetically
modified T cells directed against CD19 for pediatric and young adult patients with relapsed / refractory CD19 + leukemia (NCT02028455).
After infusion, the signal from the genetically
modified T cells in the peripheral blood increased up to 100-fold and the DNRII - LSTs persisted for up to 4 years, according to the authors.
Potentially everyone can benefit from gene
modified T cells and there's no danger of graft versus host disease because it's not a transplant from another person.
Chimeric antigen receptor -
modified T cells in chronic lymphoid leukemia.
Two men who had even higher levels of
the modified T cells experienced a dramatic recovery.
The modified T cells contain a protein known as a chimeric antigen receptor (CAR), which is designed to target the CD19 protein found on the surface of B cells, including the cancerous B cells that characterize several types of leukemia and lymphoma.
The modified T cells are then infused into the patient's bloodstream, where they target and kill cancer cells.
In animal models,
the modified T cells greatly reduced the tumor burden and prolonged overall survival: All mice that received
the modified T cells were alive 44 days after treatment versus 29 percent and 17 percent of the study's two control groups.
Those modified T cells are injected back into the patient to seek out and destroy the cancer.
An APC - mimetic scaffold that was engineered to activate a specific type of CAR - T cell was able to generate higher numbers of
the modified T cells over longer periods of culture than analogously designed expansion beads, and the resulting cells were similarly effective in killing the lymphoma cells in the mice.
The modified T cells are then reinfused back into a patient and, if all goes well, attack the person's NY - ESO - 1 — displaying tumors.
Well - engineered CARs are key, but successful therapy also requires close encounters between cancer and
the modified T cells.
Yet four weeks after receiving
the modified T cells, nearly all of it was gone.
The patients received injections of their genetically
modified T cells over three days, and then the waiting game began.
After
the modified T cells make many copies of themselves in the lab, they're unleashed in the patient's bloodstream to find and kill cancer cells.
In this case,
modified T cells destroy the myelin sheath surrounding nerve cells.
For the past several years, researchers have been
modifying T cells so they can attack leukemia, but the cells must be painstakingly isolated from the patients themselves and grown in a lab.
For
every modified T cell infused into the patients» blood, at least 1000 tumor cells were killed, leading the researchers to dub the T cells «serial killers.»
Using a novel technique to genetically
modify T cells for adoptive transfer, Carl June, Michael Kalos, David Porter, Bruce Levine, and colleagues at the University of Pennsylvania School of Medicine achieve clinical responses in patients with chronic lymphocytic leukemia, including two complete, durable (one year) clinical responses, accompanied by in vivo expansion and long - term functional persistence of gene - modified cells.
Not exact matches
The institute, which includes over 40 laboratories and more than 300 researchers, said the research would focus on
modifying a patient's own immune system
T -
cells to target a tumor, studying ways to boost patient response to current immunotherapy drugs.
In clinical trials the treatment — which involves extracting individual patients» immune
T -
cells,
modifying them to seek out tell - tale biological markers associated with blood cancers like aggressive lymphoma, and then pumping those
modified killer
cells back into the body — has shown major promise, in some cases eliminating all signs of the cancer in patients six months after treatment.
Health service chief calls for affordable access to CAR -
T, which
modifies immune system to destroy cancer
cells
A transformative cancer therapy based on
modified immune
cells has lured doctors, companies, and patients alike, but many are hitting a frustrating roadblock: generating enough of these chimeric antigen receptor (CAR)-
T cells to meet surging demand.
Researchers are developing many different versions of CAR -
T cell therapies, but the basic premise is the same: Doctors remove a patient's
T cells (immune system
cells that attack invaders) from a blood sample and genetically
modify them to produce artificial proteins on their surfaces.
CANCER CRUSH In CAR -
T cell therapy, a cancer treatment approved by the FDA this year for certain blood cancers, a patient's
T cells (teal) are genetically
modified to hunt down and kill cancer
cells (blue).
The proposed CRISPR trial builds off the pioneering efforts of Carl June and others at University of Pennsylvania (UPenn) to genetically
modify a cancer patient's own immune
cells, specifically a class known as
T cells, to treat leukemia and other cancers.
Adoptive
cell transfer procedures are mimicking exactly this process in a culture dish by taking
T cells from patients, multiplying them, sometimes genetically
modifying them, and then returning them to patients so that they can, for example, locate and kill cancer
cells.
In adoptive immunotherapy,
T cells are harvested, amplified or otherwise
modified, and reinfused to boost the anticancer immune response.
Novel methods to turn these
modified T -
cells off after a certain time are one way around this potential complication.
According to the 6 April report in the Journal of Assisted Reproduction and Genetics, researchers at Guangzhou Medical University in China attempted — with limited success — to
modify the CCR5 gene, which codes for a
cell receptor that the HIV virus uses to enter
T cells.
In yet another approach, researchers could
modify specific white blood
cells (called
T -
cells) to see and target pancreatic cancer
cells, although this therapy could attack healthy
cells, too.
On the safety side, the panelists delved into the possible risks of injecting genetically
modified cells into patients, including the potential for deadly viral infections, brain toxicity, and, paradoxically, the growth of new tumors brought about by CAR -
T cells years after treatment.
Genetically
modified «hunter»
T cells successfully migrated to and penetrated a deadly type of brain tumor known as glioblastoma (GBM) in a clinical trial of the new therapy, but the
cells triggered an immunosuppressive tumor microenvironment and faced a complex mutational landscape that will need to be overcome to better treat this aggressive cancer, Penn Medicine researchers report in a new study this week in Science Translational Medicine.
But Nabel noticed that this
modified adenovirus alone stimulated rapid antibody production, and even produced a
T -
cell response, although at a lower level than the DNA vaccine.
When the researchers restored
T cells to the
modified rodents, however, their blood pressure surged.
The researchers
modified a type of human immune
cell — called
T lymphocytes, or
T cells — to target a molecule called CS1, which is found on more than 95 percent of myeloma
cells, and to kill the
cells.
Beilhack and colleagues found that a slightly
modified version of STAR2 has a similar effect on human
T reg
cells, suggesting that the approach could also prevent GvHD in leukemia and lymphoma patients after bone marrow or hematopoietic stem
cell transplants.
The team is also hoping to test
T cells modified to attack breast, lung, and colon tumors.
The researchers found that in genetically -
modified mice lacking Interferon - 1, who were also fed a high - fat diet, the CD8 +
T cells did not produce an inflammatory response, and the mice had near normal blood sugar levels.
A study led by UCLA's Drs. Robert Prins and Linda Liau, both UCLA Jonsson Comprehensive Cancer Center members, looked at the impact of a combined treatment using a chemotherapy drug called decitabine and genetically
modified immune
cells or
T cell immunotherapy.
Until recently, however, editing human
T cells with CRISPR / Cas9 has been inefficient, with only a relatively small percentage of
cells being successfully
modified.
The trial participants had
T cells removed from their blood and then
modified in the laboratory with a designer enzyme engineered by Sangamo BioSciences in Richmond, California.
Several early stage clinical trials using autologous infusions of ZFN - generated CCR5 -
modified CD4 +
T cells are currently underway (clinicaltrials.gov identifiers NCT00842634, NCT01252641, NCT01044654).
The team is already using the new high - throughput SuFEx to
modify drugs targeting the immune system's
T cells, he adds.
The recent research, published in the journal Blood, centered on the discovery of «epigenetic checkpoints» in
T -
cell function in an effort to explain how and why these
cells are
modified to behave differently.
However, coreceptor - specific ZFNs represent a novel therapeutic approach to recapitulate this success via autologous transplantation of gene -
modified hematopoietic stem
cells and mature CD4 +
T cells.
There's also a long - term risk from the gene therapy that we think is small, because we've genetically altered the
T cells with a viral vector that's actually a
modified, non-pathogenic form of HIV, the AIDS virus.