CAR-T cell therapy and its application in clinical cancer treatment

Background: Cancer, defined by the World Health Organization (WHO) is “a large group of diseases characterized by the growth of abnormal cells beyond their usual boundaries that can then invade adjoining parts of the body and/or spread to other organs”. From extensive surgical excisions, radiotherapy, laser therapy to immunotherapies, various treatment strategies have been proposed and implemented so far but unfortunately none could improve the five year survival rate of the patients globally. Immunotherapy, being one amongst them, is a type of cancer treatment that boosts the body’s natural defenses to fight against cancer. The current concept of immunotherapy involves Chimeric antigen receptor or the CAR T-Cell therapy which involves alterations and modifications of T cells to fight cancer cells better. Until recently, the use of CAR T-cell therapy has been restricted to small clinical trials, largely in patients with advanced blood cancers and has also shown a promising window of hope in head and neck (especially oral) cancers as well. But these treatments have nevertheless captured the attention of the people because of the remarkable responses they have produced in some patients for whom all other treatments had stopped working. The current concept of immunotherapy involves the cancer vaccines making use of CAR T-cells which are the most powerful antigen presenting cells for the induction of antigen specific T cell response. This evidence based study therefore aims to highlight the clinical perspective of CAR T-Cell based immunotherapy in oral and other head and neck cancers. Aim: Assessment of efficacy of Car T-Cell Therapy in head and neck Malignancies. Research Question: Is Car T-Cell Therapy actually effective in treating head and neck cancers? Materials and Methods: Study sample included review of 70 research articles, based on scientific data bases from the English literature based COCHRANE collaboration having a definite RCT (Randomized Control Trial). The literature was studied, analyzed and assessed; comparison was made on their p (probability) values between various techniques in terms of their sensitivity and specificity. The articles were scrutinised based on the criterion for meta-analysis and finally 11 study articles were chosen for the study. Result and Conclusion: Due to its unique individual characteristics, it helps combat against the cancer cells at its very inception. Promises a complete and permanent cure for malignancies at the grass root level. It has a sensitivity and specificity of greater than 80-90% and enhances recovery rate from 40-50% to more than 90%. So on a bulls eye view, we can say that as the already existing techniques of oral cancer treatment are very superficial and not very significant, Car T-Cell therapy tends to bring about a paradigm shift in oral cancer treatment thereby giving a new ray of hope to cancer ailing patients.

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Clinical Cancer Advances 2018: Annual Report on Progress Against Cancer From the American Society of Clinical Oncology

Journal of Clinical Oncology ◽

10.1200/jco.2017.77.0446 ◽

2018 ◽

Vol 36 (10) ◽

pp. 1020-1044 ◽

Cited By ~ 67

Author(s):

John Heymach ◽

Lada Krilov ◽

Anthony Alberg ◽

Nancy Baxter ◽

Susan Marina Chang ◽

...

Keyword(s):

Cancer Research ◽

T Cell ◽

Cell Therapy ◽

Precision Medicine ◽

T Cell Therapy ◽

Clinical Cancer ◽

Car T Cell ◽

Car T Cell Therapy ◽

Car T ◽

Adoptive Cell Immunotherapy

A MESSAGE FROM ASCO’S PRESIDENT I remember when ASCO first conceived of publishing an annual report on the most transformative research occurring in cancer care. Thirteen reports later, the progress we have chronicled is remarkable, and this year is no different. The research featured in ASCO's Clinical Cancer Advances 2018 report underscores the impressive gains in our understanding of cancer and in our ability to tailor treatments to tumors’ genetic makeup. The ASCO 2018 Advance of the Year, adoptive cell immunotherapy, allows clinicians to genetically reprogram patients’ own immune cells to find and attack cancer cells throughout the body. Chimeric antigen receptor (CAR) T-cell therapy—a type of adoptive cell immunotherapy—has led to remarkable results in young patients with acute lymphoblastic leukemia (ALL) and in adults with lymphoma and multiple myeloma. Researchers are also exploring this approach in other types of cancer. This advance would not be possible without robust federal investment in cancer research. The first clinical trial of CAR T-cell therapy in children with ALL was funded, in part, by grants from the National Cancer Institute (NCI), and researchers at the NCI Center for Cancer Research were the first to report on possible CAR T-cell therapy for multiple myeloma. These discoveries follow decades of prior research on immunology and cancer biology, much of which was supported by federal dollars. In fact, many advances that are highlighted in the 2018 Clinical Cancer Advances report were made possible thanks to our nation’s support for biomedical research. Funding from the US National Institutes of Health and the NCI helps researchers pursue critical patient care questions and addresses vital, unmet needs that private industry has little incentive to take on. Federally supported cancer research generates the biomedical innovations that fuel the development and availability of new and improved treatments for patients. We need sustained federal research investment to accelerate the discovery of the next generation of cancer treatments. Another major trend in this year’s report is progress in precision medicine approaches to treat cancer. Although precision medicine offers promise to people with cancer and their families, that promise is only as good as our ability to make these treatments available to all patients. My presidential theme, “Delivering Discoveries: Expanding the Reach of Precision Medicine,” focuses on tackling this formidable challenge so that new targeted therapies are accessible to anyone who faces a cancer diagnosis. By improving access to high-quality care, harnessing big data on patient outcomes from across the globe, and pursuing innovative clinical trials, I am optimistic that we will speed the delivery of these most promising treatments to more patients. Sincerely, Bruce E. Johnson, FASCO ASCO President, 2017 to 2018

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