How CAR T- became the moon-shot in Cancer Treatment?

Background:

Surgery, radiotherapy, and systemic therapy are the three main types of cancer treatment (administering medicines that act on the tumour). While systemic therapy has experienced unsurpassed advancements, surgery and radiotherapy have both shown considerable improvements over time. CAR T-cell therapy is a recent advancement in this field that is currently attracting the interest of several experts across the globe.

CAR T :

A form of immunotherapy known as “chimeric antigen receptor (CAR) T-cell therapy” alters the immune system of a cancer patient to make it more adept at locating and eliminating cancer cells. T cells are used in CAR T-cell therapy because they often eliminate malignant cells and virus-infected cells.

How CAR T cell therapy work ?

It may also be referred to as a form of adoptive cell transfer. CAR T-cell therapy is a highly technical and specialized medical procedure. A expert gathers and modifies your T cells throughout this procedure. You receive a drip that contains these cells back into your bloodstream after a few weeks. The CAR T cells then identify and target the cancer cells for attack. CAR T-cell treatment directs T cells to target an antigen, which is present on the surface of specific cancer cells and is perceived as dangerous by the body. To aid the T cells in achieving this focus, a protein is added to their surface during the creation of CAR T cells. The chimeric antigen receptor, or CAR, is the name of this protein. This CAR protein is composed of three different proteins: one that identifies antigens on cancer cells, and two that alert the T cell to become activated when the first protein binds to an antigen on a cancer cell.

" CAR T cells search for cells that carry the antigen encoded into CAR protein, such as specific cancer cells, as they float around the body "

CAR T therapy not a solution for everyone !!

It is crucial to understand that prior cancer treatments frequently have an impact on T cells and may leave them less healthy. When T cells are transformed into CAR T cells, they should ideally be in the best condition. This frequently means that a person's T cells must be collected during a break in treatment. In order to collect as many healthy T cells as possible, the doctor must take special care to ensure that the cancer won't be overly active or result in too many symptoms while treatment is paused. This is the most challenging step in the process for some cancer types, and as a result, some patients may not be candidates for CAR T-cell therapy. The T cells are gathered using a procedure known as apheresis once a predetermined amount of time has passed without treatment. During apheresis, the patient's blood is circulated through a device that removes T cells before returning the remaining blood to them. After that, a manufacturer receives the cells and turns them into CAR T cells, which typically takes 3 to 6 weeks. The person's normal T cells are activated, multiplied, and infected with a virus during the manufacturing process, which leads to genetic modification and the addition of the CAR to the T cell. Meanwhile the person can continue receiving their normal cancer treatment while awaiting the completion of manufacturing.

Before injecting the CAR T cells into the cancer patient, the doctor administers a brief course of chemotherapy called lymphodepletion over the course of two to three days. This prevents the body's immune system from misinterpreting the CAR T cells as abnormal and rejecting them. The CAR T cells are then removed from the freezer, defrosted, and administered through the blood in a manner akin to a blood transfusion.

References:

1. https://medsurgeindia.com/how-does-car-t-cell-therapy-work-in-treating-cancer/