Clinical Corner - May 2022

Cancer is an elusive disease – one that can hide from our body’s immune defenses and even hijack those defenses for its own purposes. To battle the disease, systemic treatments have long relied on the twin cudgels of chemotherapy, to poison the cancer cells and radiation, to blast them to death. The treatments can be lifesaving, but they also carry significant side effects.

An alternative is to empower our immune systems to recognize and destroy cancer. Cancer “immunotherapy,” as it is called, works by weaponizing immune cells to perform what are, in essence, highly precise drone strikes on cancer cells. This approach, known as chimeric antigen receptor (CAR) T-cell therapy, involves extracting a small number of white blood cells called T cells from a patient’s blood, then genetically modifying them to kill cancer. Those cells are then infused back into the patient. The entire process takes about two weeks, as opposed to other processes that can take months. The genetically engineered CAR T cells continue to replicate in the body, generating a population of hundreds of millions within a few days – a veritable army of cancer killers. CAR T-cell therapy has redefined the paradigm for how to treat children and adults with certain hematological malignancies.

Although CAR T therapy has achieved impressive outcomes in patients with hematologic cancers, similar results for those with solid tumors have remained elusive. Hopefully, new CAR T treatments will show activity against relapsed or refractory advanced solid tumors. The data entered into and retrieved from our cancer registries will pave the way for these exciting possibilities.