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Cancer Treatment

CAR T-Cells: A journey through cancer treatment

This article deals with CAR T-cells, a innovation in cancer treatment in the modern era that has shown great success and promise for a brighter future.

As we continue on our journey to understanding cancer treatment, we have discussed various cancer treatments, such as immunosurveillance and monoclonal antibodies. This article deals with a novel cancer treatment known as CAR T cell therapy that first received FDA approval in 2017. What are CAR T-cells? CAR T-cells are Chimeric Antigen Receptors (CAR) that are artificially introduced into T-cells through genetic modification. These receptors are designed to bind to a specific protein (antigen) on a cancer cell like a lock and key mechanism. 

T-cells are white blood cells that are part of the immune system and play a significant role in the immune response. These T-cells are taken from the patient and modified in a lab to include a receptor that is specific to a certain cancer type. These modified T-cells are reinjected into the patient leading to an immune response against the cancer cells, thereby destroying it.

The first generation of CAR T-cells were developed in 1993 but they were not effective at all and did not persist in the body. By 2010, the scientists showed in the laboratory that T-cells were better engineered to fight against cancer. In 2012, CAR-T cells were first used by Carl June, David Poret, and Stephan Grupp on Emily Whitehead, a 6-year old patient with ALL (Acute lymphoblastic leukemia). Emily had gone through several treatments prior to CAR T-cell therapy, such as bone marrow transplant and chemotherapy. However, none of these treatments worked and her leukemia became so severe that doctors recommended stopping all further treatment. However, in April 2012, Emily enrolled in a Phase I trial and became the first child to receive the CAR T-cell therapy and was in remission by late 2012. 

CAR T-cells are a significant improvement in the world of cancer therapy for several reasons. First, it’s a therapy that works forever because once injected into the patient, the CAR T-cells remain in the patient’s immune system through their lifetime. Second, it is highly specific as discussed earlier. They are sometimes called a “living drug” since they can detect and fight off cancer cells for many years. This therapy has also led a lot of patients into remission, and the success rate is between 80-90%.

One of the main side effects of  CAR T-cell therapy is cytokine release syndrome, which is when a patient has extremely high fevers and extremely low blood pressure. Other effects of the CAR T-cell therapy include seizures, confusion, changes in the brain, and more. Currently, this therapy is not available for all cancer types, as it has only been developed for some B-cell blood cancers, such as  DLBCL (diffuse large B-cell lymphoma) and ALL. This limits the type of cancers that can be treated with CAR T-cells. 

CAR T-cell therapy is a major innovation in cancer therapy and in spite of its current limitations, it holds promise for future cancer therapy and treatments. 

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