Chemotherapy's emergence as a novel treatment for cancer in the late 1950s heralded a new era in which cancers that had spread could be treated, maintained, or even cured. Patients no longer had to rely on surgery, radiotherapy, hyperthermia, or other traditional methods of treating tumor growth alone. By deploying some or all of these treatment modalities with chemotherapy, oncologists were often able to see high rates of remission and combination chemotherapy remains a popular cancer treatment to this day.
However, chemotherapy is also well-known for its long list of side-effects, from hair loss and nausea to headaches and muscle damage — which can lower the quality of life for patients being treated for cancer. In the 2000s, the National Cancer Institute (NCI) explains, targeted treatments for cancer emerged, offering a less scattershot means of attacking otherwise uncontrolled cellular growth and becoming the “standard” for care across many cancers.
Since 2017, several new, highly personalized drugs called immunotherapeutics, which the NCI describes as “therapies that enlist and strengthen the power of a patient's immune system to attack tumors,” have been approved by the Food and Drug Association (FDA) as first- and second-line therapies for certain cancers. Some promising early results have shown immunotherapies treating patients effectively for years with fewer cytotoxic effects than chemo. As new cell therapies are approved, it's crucial to learn what kinds of novel therapeutics are available to your oncological patients and to stay abreast of the future of immunotherapy.
What Is CAR T cell therapy and how does it fight cancer?
Unlike targeted treatments, immunotherapies have distinct decades-long potential for keeping cancer at bay. In 2012, Matthew Vanneman and Glenn Dranoff described how “targeted approaches aim to inhibit molecular pathways that are critical to tumor growth and maintenance, whereas immunotherapy endeavors to stimulate a host response that effectuates long-lived tumor destruction,” providing the potential for long-lasting remission — and even a cure.
In the last decade, several cell-based immunotherapeutic cancer treatments using chimeric antigen receptor (CAR) T cells have been approved by the FDA. These novel courses of oncological treatment have been shown to result in even decades of remission in some adult and pediatric leukemia patients.
T cells, or T lymphocytes, are a type of white blood cell with receptors that “attach to foreign antigens” like cancer cells, the American Cancer Society says, and kick off an immune system response to fight them. CAR T cells are T cells that have been extracted from the patient’s blood and re-engineered in a lab to include the gene for producing chimeric antigen receptor proteins. The CAR gene is a synthetic molecule and not naturally occurring, explains the NCI, and the resulting CAR protein bridges the cell membrane:
