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Immunotherapy Cocktails, Like Chemotherapy Cocktails, May Benefit from Trial-and-Error Experiments



(p. A16) A new way of genetically altering a patient's cells to fight cancer has helped desperately ill people with leukemia when every other treatment had failed, researchers reported on Monday [Nov. 20, 2017] in the journal Nature Medicine.

The new approach, still experimental, could eventually be given by itself or, more likely, be used in combination treatments -- analogous to antiviral "cocktails" for H.I.V. or multidrug regimens of chemotherapy for cancer -- to increase the odds of shutting down the disease.

Researchers say the treatment may be more promising as part of a combination than when given alone because, although some patients in the small study have had long-lasting remissions, many others had relapses.

The research, conducted at the National Cancer Institute, is the latest advance in the fast-growing field of immunotherapy, which fires up the immune system to attack cancer. The new findings build on two similar treatments that were approved by the Food and Drug Administration this year: Kymriah, made by Novartis for leukemia; and Yescarta, by Kite Pharma for lymphoma.

In some cases, those two treatments have brought long and seemingly miraculous remissions to people who were expected to die.

Kymriah and Yescarta require removing millions of each patient's T-cells -- disease-fighting white blood cells -- and genetically engineering them to seek and destroy cancer cells. The T-cells are then dripped back into the patient, where they home in on protein molecules called CD19 found on malignant cells in most types of leukemia and lymphoma.

The new treatment differs in a major way: the T-cells are programmed to attack a different target on malignant cells, CD22.



For the full story, see:

DENISE GRADY. "Experimental Gene Treatment Shows Promise in Combating Leukemia." The New York Times (Tues., NOV. 21, 2017): A16.

(Note: bracketed date added.)

(Note: the online version of the story has the date NOV. 20, 2017, and has the title "New Gene Treatment Effective for Some Leukemia Patients.")


The Nature Medicine article, mentioned above, is:

Fry, Terry J., Nirali N. Shah, Rimas J. Orentas, Maryalice Stetler-Stevenson, Constance M. Yuan, Sneha Ramakrishna, Pamela Wolters, Staci Martin, Cindy Delbrook, Bonnie Yates, Haneen Shalabi, Thomas J. Fountaine, Jack F. Shern, Robbie G. Majzner, David F. Stroncek, Marianna Sabatino, Yang Feng, Dimiter S. Dimitrov, Ling Zhang, Sang Nguyen, Haiying Qin, Boro Dropulic, Daniel W. Lee, and Crystal L. Mackall. "CD22-Targeted CAR T Cells Induce Remission in B-ALL That Is Naive or Resistant to CD19-Targeted CAR Immunotherapy." Nature Medicine (published online on Nov. 20, 2017).






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