Patients with head and neck cancer are receiving a groundbreaking new treatment that involves prompting their immune systems to battle the disease.
The trial, at the National Institute for Health Research biomedical research centre at Guy’s and St Thomas’ NHS foundation trust and King’s College London, involves genetically modifying patients’ white blood cells so they recognise and attack the tumour.
White blood cells of the immune system are naturally equipped to eliminate cells – especially infected ones – that should not be there, but sometimes need help to recognise and attack cancer cells.
Using a blood sample, the BRC team is treating white blood cells in the laboratory with a harmless virus that introduces two new genes. The first gene makes it easier to grow the cells during their time in the laboratory while the second enables the white blood cells to recognise and attack the tumour.
Principal investigator Dr John Maher said: “In most cancers, metastasis, the spread of a disease from the part of the body where it started to another not directly connected, is the commonest cause of death. However, head and neck cancer is unusual in that local spread or recurrence of the disease accounts for most suffering and death. This means that tumours may become inoperable and do not shrink in response to traditional treatments such as chemotherapy or radiotherapy.”
The treatment is called a CAR T-cell and takes two weeks to produce. To maximise its safety and effectiveness the team is injecting the CAR T-cells directly into the tumour. CAR T-cell treatment has proven effective in some forms of leukaemia but the hope is that it can be developed further to benefit patients with so-called “solid cancers”, which form a discrete tumour mass, such as head and neck cancer.
Maher said success could have “significant implications for other solid cancers, especially those that spread within a natural space in the body, such as ovarian cancer (lining of the abdomen) or mesothelioma (lining of the lungs). In that setting, it may be possible to inject the CAR T-cells from the patient directly into the cavity, to localise the treatment where it is needed most”.
During the phase 1 trial, which aims to test the treatment’s safety and effectiveness, patients enrolled in groups will successively receive a higher number of cells to establish safe dosage, provided it does not produce significant side-effects. If it is successful, the treatment will need to be tested in larger numbers of patients to establish how effective it is at combating the cancer.
Dr Stephen Caddick, director of innovations at the Wellcome Trust, which co-funded the trial, said: “By precision engineering immune cells to recognise and destroy tumours, researchers are hopeful that they will be able to improve the prospects for patients who have, until now, faced very limited treatment options.”
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