More Than a Buzzword, Immunotherapy Holds Great Promise

Immunotherapy — in the area of cancer treatment, it’s the buzzword of the moment. It would be difficult to imagine an area of the field generating more excitement and hope than immuno-oncology is sparking right now.

There’s good reason for this enthusiasm. Logically, it makes sense that there should be ways to stimulate the body’s own immune system — which is naturally primed to fight disease — to attack and kill cancer. Realistically, the idea that we can make the human immune system more potent holds up: Immunotherapy has demonstrated effectiveness in an expanding range of cancer types, with some drugs of this kind already approved.

An area of particular excitement within the immunotherapy realm is chimeric antigen receptor (CAR) T cell therapies. This technique involves removing T cells (immune cells) from a patient’s body, engineering them in a lab to include a gene sequence that programs them to recognize cancer-specific proteins and demolish cancer cells, and then infusing them back into the patient. Inside the patient’s body, the T cells not only attack cancer cells, but multiply upon encountering them.

Although none have been approved yet by the U.S. Food and Drug Administration, CAR T cell therapies are being tested widely across the cancer spectrum. While it is thought that they might make excellent treatments for solid tumors, current clinical research is farthest along in the blood cancers. In fact, as we report in this special hematology issue of CURE, some very promising trials were recently conducted in both children and adults with acute lymphocytic leukemia (ALL). The results of these trials are remarkable in that they show that CAR T cell therapy extended life in many patients for a year or two or even longer, despite the fact that their ALL was relapsed or refractory.

How much CAR T cell therapy ultimately can prolong life remains to be seen, but there is hope that it will have the kind of lasting effect that few other cancer treatments have conferred. With these engineered T cells living and multiplying in patients’ bodies, our highest hope is that they will enable lifelong immunity to the cancers they treat and provide durable and even permanent remissions.

Our search for answers to this question is really just beginning, but we look forward to sharing more news with you as the story unfolds.

Debu Tripathy, MDEditor-in-ChiefProfessor of MedicineChair, Department of Breast Medical OncologyThe University of Texas MD Anderson Cancer Center