For most of modern medicine, cancer drugs have been developed the same way: by designing molecules to treat diseased cells. With the advent of immunotherapy, that changed. For the first time, scientists engineered patients' own immune systems to recognize and attack diseased cells.
, it's no longer just a theoretical possibility: CAR T cell therapy is making waves in solid tumor cancer types and even beyond cancer, for other diseases. Here, June and Baker, a member of June's lab, explain how.June: CAR T cells are derived from our own immune system. T cells are a type of white blood cell that give our bodies lifelong memory to infections. CAR T takes those immune cells and makes them cancer killers.
Baker: What's exciting is it's not just theoretical at this point. There have been clinical reports in other autoimmune diseases, including myasthenia gravis and inflammatory myopathy. It's still early, and we're not going to know for a while whether these are curative, or what the long-term effects are going to be.
But when you look at diseases that can take years to get proof that you have efficacy, then the clinical trials take longer. Just as in cancer, we'll have to start off with patients at the most critical stage of disease, where there are no other potential therapies. While earlier stage disease may ultimately be the better place to implement these therapies, we have to begin clinical trials in late-stage disease.
Most other diseases don't have their cells hiding in places that are so hard for the immune system to reach. And the hallmark of cancer is that it's constantly changing—or mutating—which isn't the case for most other diseases. The fact that CAR T cell therapy has worked so well under such difficult circumstances makes the idea of using it in other settings all the more promising.
The science is rapidly being solved. Back when we started, there were less than a handful of groups working on CAR T in the entire world. Now, thousands of laboratories are working on this. While the science is most effectively addressed in academic settings, where innovation occurs more rapidly, the progress on manufacturing is happening primarily within the biopharma industry.
Finally, the workforce is now hiring many more people to work on cell therapy. I've had 55 grad students in my lab since coming to Penn. When we started in 1999, if people asked about coming to my lab to work on CAR T cells, others in the field would tell them not to because it was just an academic curiosity. There was no industry or pipeline of jobs, and now that's completely changed.
There's no question that over the last decade, CAR T cell therapy has revolutionized cancer. Being given the freedom by Carl, Zolt, and other mentors to explore broadly and ask the question of whether CAR T can work elsewhere—like chronic diseases or aging—and design an ambitious project to find out is something unique to the atmosphere at Penn.
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