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Researchers launch CAR-T cell therapy trial in head and neck cancer

Published on 09/12/15 at 10:37am
A health human CAR-T cell (Credit: Celgene)

A pioneering trial is beginning in London, where doctors are harnessing patients’ own immune systems to find a new effective treatment for resistant head and neck cancer.

The trial is the first to use immunotherapy techniques, which have been successfully used to develop new treatments for several cancers, including melanoma and lung cancer, in head and neck cancers.

The trial of the novel therapy, which involves genetically engineering a patient’s white blood cells so that they recognise and attack the tumour, is taking place at the NHS-funded National Institute for Health Research (NIHR) Biomedical Research Centre (BRC) at Guy’s and St Thomas’ and King’s College London, with funding also from the Wellcome Trust and the J P Moulton Charitable Foundation.

The main goal of the trial is to test the safety and effectiveness of the new treatment as a potential treatment for head and neck cancers. Patients have been enrolled in groups of three and, if significant side effects are not seen, successive groups will receive a higher number of cells to establish safe dosage. So far the team has completed the first cohort of three patients in this ongoing trial.

The technique exploits the ability of the immune system’s white blood cells to be ‘programmed’ to recognise, attack and eliminate cancer cells. Using a blood sample, the research team is genetically engineering patients’ own white blood cells by treating them in the laboratory with a harmless virus that introduces two new genes. The first gene makes it easier to grow the cells in the laboratory, while the second enables white blood cells to recognise and attack the tumour.

The resulting treatment, called T-4 immunotherapy, is a CAR T-cell. This type of treatment is being studies by pharma companies in some forms of leukaemia but is yet to be tested in patients with solid cancers, such as head and neck cancer. Results of clinical trials with Novartis’ CAR-T cell therapy featured at this year’s American Society of Haematology conference, and the UK has invested in the technique as a future treatment for cancer.

Dr John Maher, principal investigator at the BRC, says: “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.”

Dr Maher adds: “If this trial is successful, it could have significant implications for other solid cancers, especially those that spread within a natural space in the body, such as ovarian cancer or mesothelioma. 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.”

Life Sciences Minister George Freeman MP says: “This world first trial is an illustration of the value of our £1 billion per annum National Institute for Health Research, which pioneers and tests new treatments for the benefits of patients and the NHS. Through our Accelerated Access Review, we intend to fast track breakthroughs like this.”

Dr Stephen Caddick, director of innovations at the Wellcome Trust, says: “Immunotherapy is a very exciting new approach to treating cancer, which takes advantage of the body’s own immune system to tackle the disease. 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.”

Lilian Anekwe

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