The Bob Pritchard Corner
Acute lymphoblastic leukemia is the most common cancer among young children, accounting for a quarter of all cancer cases in kids, and it has no cure. For about 85% to 90% of children, the leukemia can, however, be effectively treated through chemotherapy.
If it is not eliminated and comes back, it can often be fatal. Rounds of chemotherapy can buy patients time, but as the disease progresses, the periods of remission can become shorter and shorter. The patient could receive a bone-marrow transplant, but only about half of those procedures are successful, and there is a chance that they could reject the donor cells. If that happens, chances of surviving are very small.
There is now a radical new option, using gene therapy to train a patient’s immune system to recognize and destroy their cancer in the same way it dispatches bacteria and viruses. The strategy is the latest development in immunotherapy, a revolutionary approach to cancer treatment that uses a series of precision strikes to disintegrate cancer from within the body itself.
What saves the patient is an infusion of their own immune cells that are genetically modified to destroy the patient’s leukemia. With this therapy, 90% of patients go into remission. Such radical immune-based approaches were launched in 2011 with the success of intravenous drugs that loosen the brakes on the immune system so it can see cancer cells and destroy them with the same vigor with which they attack bacteria and viruses. Now, with the genetically engineered immune cells known as chimeric antigen receptor (CAR) T cells, doctors are crippling cancer in more precise and targeted ways than surgery, chemotherapy and radiation ever could. While the first cancer immunotherapies were broadly aimed at any cancer, experts are now repurposing the immune system into a personalized precision treatment that can not only recognize but also eliminate the cancer cells unique to each individual patient.
What makes immune-based therapies like CAR T cell therapy so promising–and so powerful–is that they are a living drug churned out by the patients themselves. The treatment isn’t a pill or a liquid that has to be taken regularly, but a one-hit wonder that, when given a single time, trains the body to keep on treating, ideally for a lifetime.
This therapy is utterly transformative for this kind of leukemia and also lymphoma. Eager to bring this groundbreaking option to more patients, including those with other types of cancers, an advisory panel for the Food and Drug Administration voted unanimously in July to move the therapy beyond the testing phase, during which several hundred people have been able to take advantage of it, to become a standard therapy for children with certain leukemias if all other treatments have failed.
Across the United States, doctors are racing to enroll people with other cancers–breast, prostate, pancreatic, ovarian, sarcoma and brain, including the kind diagnosed in Senator John McCain–in hundreds of trials to see if they will benefit from this novel approach.
NIH National Cancer Institute
Optimism is the faith that leads to achievement. Nothing can be done without hope and confidence