Treatment Update: T-cell Therapy
By: Natalie Van Hoozer

T-cell therapy is an up and coming cancer treatment process. Some of our own northern Nevada kids have received or are currently receiving this treatment. T-cell therapy, also called “immunotherapy”, utilizes the existing immune cells in a person’s body to kill cancer cells.

T-cell therapy has been used in clinical trials for patients with B-cell cancers. These include acute lymphoblastic leukemia (ALL), B-cell non-Hodgkin lymphoma (NHL), and the adult cancer chronic lymphocytic leukemia (CLL).
As the Children’s Hospital of Philadelphia states, the T-cell therapy clinical trial produced some noticeable figures:
– 27 of the 30 patients with ALL went into complete remission for a time after receiving this T-cell therapy.
– 19 of the 30 are still in remission.
– 7 of the 30 experienced a recurrence of the disease.

Here is how the T-cell therapy process works:
Initially, people with certain leukemias and lymphomas, like ALL, NHL, and CLL, have cancerous B-cells. These cells are part of the immune system and therefore are not detected as harmful by the other cells of the immune system, even when they become cancerous. T-cell therapy attempts to solve this problem by altering T-cells, which are also part of the immune system, to detect these cancerous B-cells.

This alteration requires extraction of T-cells from the patient. These T-cells are then programmed to detect a certain protein that is only present on the surface of B-cells. Once, “programmed,” these T-cells are placed back into the patient, where they kill B-cells, cancerous and noncancerous alike. The fact that they kill healthy B-cells is treatable. The important thing to note about this step is that these T-cells are able to continue to flourish inside the patient and even multiply, allowing them to kill B-cells for extended periods of time.

Why T-cell therapy matters:
– It’s personalized. A patient’s own T-cells are used to go after that patient’s specific type of cancer.
– It could potentially be a less invasive alternative to stem cell transplants, which are currently the major treatment for people with ALL. While stem cell transplants are effective for many patients, they can be dangerous and taxing to undergo.
Currently a main side effect of T-cell therapy is cytokine release syndrome, an immune response that can cause the hormone cytokine to trigger fever, aches, drops in blood pressure, and breathing trouble. However, this is currently being combated by immunomodulating drugs, which are now being incorporated into T-cell therapy.

It is also important to note that T-cell therapy is for patients who have not responded to standard chemotherapy and whose disease returns after a bone marrow transplant. What’s more, the number of patients who have received this treatment is small, so further trials will need to be conducted to obtain more concrete results.

However, with the Breakthrough Therapy award from the U.S. Food and Drug Administration in July of 2014, this treatment provides hope for the future. Hopefully, T-cell therapy can help in the fight against cancers like ALL.