Patients with head and neck cancer are getting a revolutionary new treatment that involves stimulating their immune systems to fight the disease.
The trial involves genetically modifying the white blood cells of patients so that they recognize and attack the tumour. The trial was conducted at The National Institute for Health Research biomedical research centre at Guy’s and St Thomas’ NHS foundation trust and King’s College London.
The immune system’s white blood cells are naturally equipped to eliminate cells – particularly the infected ones – that should not be there, but sometimes need assistance to recognize and attack cancer cells.
The BRC team, using a blood sample, is treating white blood cells in the laboratory with a harmless virus that brings in two new genes. The first gene makes growth of the cells easier during their time in the laboratory, while the second permits the white blood cells to recognize and attack the tumour.
Dr John Mayer, principal investigator, stated that in most cancers, metastasis is the most common cause of death. However, head and neck cancer is not common in that local spread or recurrence of the disease accounts for majority of suffering and death. Therefore tumours may become inoperable and do not reduce in size in response to traditional treatments such as radiotherapy or chemotherapy.
The treatment is called CAR T-cell and takes 14 days to produce. To maximize its effectiveness and safety the team is injecting CAR T-cells directly into the tumour. This treatment has proven effective in some types of leukemia, but the hope is that it can be developed more to benefit patients with “solid cancers,” which produce a discrete tumour mass, like head and neck cancer.
Maher stated that success could have remarkable implications for other solid cancers, particularly those that spread within a natural space in the body, like ovarian cancer or mesothelioma (lining of the lungs). In that situation, it may be possible to inject the CAR T-cells from the patient straight into the cavity, in order to localize the treatment where it is required most.
During the phase 1 trial, which has a goal to test the effectiveness and safety of the treatment, patients enrolled in groups will successively get a higher number of cells to establish safe dosage, provided it does not result in significant side-effects. If successful, the treatment will have to be tested in bigger numbers of patients to identify how effective it is at battling the cancer.
Director of innovations at the Wellcome Trust (which co-financed the trial), Dr Stephen Caddick, stated that by precision engineering immune cells to recognize and attack tumours, researchers hope that they will be able to improve the chances for patients who have, until now, had very limited treatment options.