CAR -T Cancer Treatment Has Surprising Success in Numerous Myeloma
by Associated Press
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Doctors are reporting unprecedented success from a fresh cell and gene therapy for numerous myeloma, a blood cancer that’s on the rise. Albeit it’s early and the investigate is petite — thirty five people — every patient responded and all but two were in some level of remission within two months.
In a 2nd investigate of almost two dozen patients, everyone above a certain dose responded.
Experts at an American Society of Clinical Oncology conference in Chicago, where the results were announced Monday, say it’s a very first for numerous myeloma and infrequent for any cancer treatment to have such success.
Chemotherapy helps ten to thirty percent of patients; immune system drugs, thirty five to forty percent at best, and some gene-targeting drugs, seventy to eighty percent, “but you don’t get to 100,” said Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society.
“These are astounding results” but time will tell if they last, he said.
Numerous myeloma affects plasma cells, which make antibodies to fight infection.
More than 30,000 cases occur each year in the United States, and more than 115,000 worldwide. It’s the 2nd fastest growing cancer for dudes and the third for women, rising two to three percent per year, according to the National Cancer Institute. About 60,000 to 70,000 Americans have it now.
Nine fresh drugs have been approved for it since two thousand but they’re not cures; only about half of U.S. patients live five years after diagnosis.
With cell therapy, “I can’t say we may get a cure but at least we bring hope of that possibility,” said Dr. Frank Fan. He is chief scientific officer of Nanjing Legend Biotech, a Chinese company that tested the treatment with doctors at Xi’an Jiaotong University.
The treatment, called CAR-T therapy, involves filtering a patient’s blood to eliminate immune system soldiers called T cells. These are altered in a lab to contain a gene that targets cancer and then given back to the patient intravenously.
Doctors call it a “living drug”– a one-time treatment to permanently alter cells that multiply in the figure into an army to fight cancer. It’s shown promise against some leukemias and lymphomas, but this is a fresh type being attempted for numerous myeloma, in patients whose cancer worsened despite many other treatments.
In the Chinese explore, nineteen of thirty five patients are long enough past treatment to judge whether they are in finish remission, and fourteen are. The other five had at least a partial remission, with their cancer greatly diminished. Some are more than a year past treatment with no sign of disease.
Most patients had a group of side effects common with this treatment, including fever, low blood pressure and trouble breathing. Only two cases were severe and all were treatable and improvised, doctors said.
The 2nd investigate was done in the U.S. by Bluebird Bio and Celgene, using a cell treatment developed by the National Cancer Institute. It tested four different dose levels of cells in a total of twenty one patients. Eighteen are long enough from treatment to judge effectiveness, and all fifteen who got an adequate amount of cells had a response. Four have reached total remission so far, and some are more than a year past treatment.
” I can't say we may get a cure but at least we bring hope of that possibility.”
The results are “very remarkable” not just for how many responded but how well, said Dr. Kenneth Anderson of Dana-Farber Cancer Institute in Boston.
“We need to be looking for how long these cells persist” and keep the cancer under control, he said.
Dr. Carl June, a University of Pennsylvania researcher who received the conference’s top science award for his early work on CAR-T therapy, said “it’s very uncommon” to see everyone react to a treatment. His lab also had this happen — all twenty two children testing a fresh version of CAR-T for leukemia responded, his colleagues reported at the conference.
“The very first patients we treated in two thousand ten haven’t relapsed,” June said.
Dr. Michael Sabel of the University of Michigan called the treatment “revolutionary.”
“This is truly the epitome of personalized medicine,” extending immune therapy to more types of patients, he said.
Legend Biotech plans to proceed the investigate in up to one hundred people in China and plans a explore in the U.S. early next year. The treatment is expected to cost $200,000 to $300,000, and “who’s going to pay for that is a big issue,” Fan said.
“The manufacturing process is very expensive and you can’t scale up. It’s individualized. You cannot make a batch” as is done with a drug, he said.
Nick Leschly, Bluebird’s chief executive, said the next phase of his company’s investigate will test what seems the ideal dose in twenty more people.