A SHORT HISTORY OF AUTOLOGOUS CAR T THERAPY
AUTOLOGOUS CAR T THERAPY
Autologous chimeric antigen receptor (CAR) T cell therapy involves collecting a patient’s white blood cells, including T cells, sending them to a manufacturing facility, and genetically engineering the T cells to recognize and kill cancer cells. The reprogrammed cells are then sent back and infused into the patient.
Autologous CAR T therapy is a kind of cell therapy, which in turn, is a kind of immunotherapy. Other immunotherapies include monoclonal antibodies (mABs), immunomodulatory imide drugs (IMiDs), cytokines (including interleukins and interferons), and cancer vaccines. They fight cancer by activating or suppressing a patient's immune system and have become important cancer treatment options along with surgery, chemotherapy, radiation therapy, and targeted therapies.
AUTOLOGOUS CAR T THERAPY— THE FIRST REVOLUTION
This approach produced remarkable responses in some patients for whom all other treatments had stopped working. Recognizing the clinical benefits, in 2017, the US Food and Drug Administration (FDA) approved 2 autologous CAR T cell therapies for patients with certain types of hematologic cancers: relapsed or refractory acute lymphoblastic leukemia and relapsed or refractory large B cell lymphoma. Despite successful patient outcomes for many, these autologous CAR T therapies have certain limitations.
KEY LIMITS OF AUTOLOGOUS CAR T THERAPY
LENGTHY
VEIN-TO-VEIN TIME
- Lengthy wait time in patients with very poor prognosis
- Not all eligible patients may receive therapy
VARIABLE POTENCY
- Compromised T cells in patients may affect product potency
- T cell variability may result in unpredictable treatment outcomes
HIGH PRODUCTION COST
- Complicated logistics and inefficiency of scale
- Limited availability
MANUFACTURING SHORTFALLS
- Creating an inventory of individualized therapy is not an option
- The potential for retreatment is limited by available patient starting material