什么是CAR-T细胞疗法?

大车 19 是根据患者自身细胞破坏白血病细胞的治疗方法.

CAR T细胞疗法, 像所有形式的癌症免疫疗法, seeks to sharpen and strengthen the immune system’s inherent cancer-fighting powers. It involves treating patients with modified versions of their own immune system T cells ­– white blood cells that help protect the body from disease.

Extracting T cells from the patient (cells from the immune system) by apheresis, a technique which allows the separation of the components of the blood, obtaining a determined quantity of lymphocytes. These are subsequently modified so that they recognise and attack the tumour cells, and they are then transferred back to the patient’s body so that, after being reprogrammed, they can recognise, attack and destroy the cancer cells.

Both the leukaemias and lymphomas that are produced by an alteration or malignisation of the B cells, have in common that they express a protein or antigen on their surface, called CD-19. When a cancer occurs, the lymphocytes cannot recognise the antigen and, therefore, cannot attack or stop the replication of cancer cells. Thanks to genetic engineering, it is now possible to reprogram lymphocytes and introduce genetic information so that, on their surface, these cells express the chimeric receptor or CAR-T that will recognise the tumour antigen (CD19) and destroy the malignant cells.

This treatment has recently been authorised by the European Medicines Agency (EMA) and approved for healthcare use, so its use is now possible on prescription and not only in the framework of clinical trials.

PHASES OF TREATMENT WITH CAR-T 19
Apheresis
During the patient’s hospital stay, white blood cells, including the T cells, are extracted by means of a collection system (leukapheresis). These cells are sent for modification and subsequent cryopreservation.
Cell reprogramming
The cells (T-lymphocytes) are genetically modified to recognise cancer cells, as well as other cells that express the specific antigen that is to be destroyed.

Expansion
Modified T-cells are multiplied, frozen and, after passing a strict quality control process, sent to the hospital where the patient is.

Patient preparation
Prior chemotherapy is administered to the patient to prevent possible rejection of the organism and to allow CAR-T cells to graft and proliferate. The ultimate goal is to help the body accept the reprogrammed CAR-T cells.
Infusion
The modified T-cells are administered by an intravenous infusion, similar to a transfusion.

Attack of the cells
如果治疗按预期进行, 一旦进入病人的血液, 浓缩输注的CAR-T细胞攻击B细胞并开始根除癌细胞.

监控方式

监测与结果
结果, 已经发表在科学期刊上, 建议超过 80% 接受这种新疗法的儿童和青少年, 在治疗的前三个月已经缓解.

CAR-T细胞: 三种先进疗法的融合

大车 19 结合三种先进的疗法: 细胞治疗, immunotherapy and gene therapy. It is considered a cell therapy as it is not a drug, but a “live” medication that is infused into the patient. It is also an immunotherapy, as the cells from the child or the adolescent’s own immune system are those that are going to fight the cancer cells. And thirdly, it is a gene therapy (one of the first approved by the FDA) as the lymphocytes are genetically modified to fight the disease.


NBScience

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