A single human immune cell. With CAR T cell therapy, these tiny powerhouses are taught to find and destroy tumor cells.
One of the most promising areas of cancer research and treatment is immunotherapy, in which a patient’s own immune system is enlisted in the fight against cancer.
This approach is more than just a narrow field of study at City of Hope. It is the central component of groundbreaking research and clinical trials currently underway to further expand its effectiveness in the treatment of cancer. City of Hope continues to be at the forefront of research into a powerful form of immunotherapy known as CAR T cell therapy. In this approach, the clinical and research medical team starts with modification of T cells obtained from a patient. These cells are then genetically modified with a lab-made chimeric antigen receptor—the “CAR” in CAR T cell. This genetic modification now enables cells to recognize a protein on the surface of a specific cancer cell. The therapeutic CAR T cells are then expanded in the lab to a population in the billions. Then they are reinfused into the patient, with the hope that the CAR T cells will seek out and kill cancer cells in the patient while sparing healthy cells.
City of Hope’s history with cell therapy dates back to the 1976 and builds on the pioneering work of City of Hope’s bone marrow transplantation program, one of the first six programs in the United States. Back then, City of Hope doctors performed one of the first successful bone marrow transplants in the nation to treat and cure leukemia. The bone marrow transplantation program has since grown into one of the largest, most successful of its kind in the United States. Led by Stephen J. Forman, M.D., currently the director of City of Hope’s Hematologic Malignancies Research Institute, more than 16,000 bone marrow transplants have been performed at City of Hope, with exceptional survival rates, according to the Center for International Blood & Marrow Transplant Research.
City of Hope’s work in the transplant field led to recognizing the importance of anti-cancer donor immunity in curing leukemia. The development of its CAR T research in the late 1990s was to design a more specific immune therapy for cancer without transplant and one that would target the cancer.
Among the diseases for which City of Hope physicians and scientists have developed CAR T cell therapy are lymphoma, acute lymphoblastic leukemia, acute myeloblastic leukemia and multiple myeloma. In addition to cancers of the blood and immune system, City of Hope researchers have developed CAR T cell therapies for treatment of patients with malignant brain tumors, prostate, ovarian and breast and other cancers.
City of Hope’s CAR T trials for glioblastoma—a type of aggressive brain tumor—were the first in the world to inject engineered CAR T cells directly into the tumor site and cerebrospinal fluid. A case report was published in 2016 in the New England Journal of Medicine, showing the potential of CAR T cells to shrink tumors residing in the brain.
Non-Hodgkin’s lymphoma patient Chuck Fata was nearly out of options when he came to City of Hope for CAR T cell therapy. Four years later, he remains cancer-free.
City of Hope has one of the most comprehensive CAR T cell programs in the world, with more than 30 CAR T cell clinical trials ongoing, treating both hematologic malignancies and solid tumors with plans to add additional trials to our CAR T clinical trial portfolio in the coming year. Some of these will be combination trials with other immune therapies with CAR T cells to further improve the efficacy. City of Hope has treated more than 500 patients with CAR T therapy to date.
City of Hope, with its clinical care, research and production facilities all on one campus, is uniquely positioned to lead this effort. Few institutions are capable of harnessing the same comprehensive “bench to bedside” resources necessary for the discovery, translational research, clinical development, manufacturing, quality assurance and delivery of leading-edge treatments for its patients for CAR T cells. City of Hope has the ability to harvest, genetically modify, reprogram, grow and then deliver T cells and care for the patients all on the same campus.
City of Hope researcher Saul Priceman, Ph.D., trains CAR T cells to seek out and destroy solid tumors.
Key to City of Hope’s success in advancing lifesaving CAR T cell therapy is its legacy of patient-centered care—treating not just the illness but caring for the entire patient. The community there includes researchers, scientists, doctors, nurses and supportive care professionals, each of whom is dedicated to giving patients the chance to live longer, better and more fully.
While it is being investigated for the treatment of many kinds of cancer, CAR T cell therapy is currently only available to certain patients, often those with relapsed disease or disease that has not responded well to other treatments.
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