Reversible cancer treatment may reverse autoimmune disease

Developing a second cancer may be an acceptable risk in treating life-threatening cancers, but it may not be due to autoimmunity, says Matt Lunning, medical director of gene and cellular therapy at Nebraska Medicine in Omaha. How to link the risk between the complications of autoimmune diseases, which can be very serious, and the complications of future studies or cancer is still a big open question.

Researchers are already working on second- and third-generation CAR T cells that they hope will be safer against cancer and autoimmunity. For example, James Howard, a neuromuscular neurologist at the University of North Carolina at Chapel Hill, is testing a technology from a company called Cartesian Therapeutics that uses CAR. mRNA moleculeslong-lived messenger for use in the Covid-19 vaccine, instead of long-lived DNA. CAR T cells must destroy B cells for as long as the mRNA is present, and then lose their ability to target cells. In the absence of a chance for the genetically modified T cells to stay around for long, there should be no risk of cancer.

Another addition to the Cartesian method: Doctors inject these T cells in sufficient numbers that they do not need to reproduce in the patient’s body, which Howard thinks reduces the risk of inflammation. In a recent trial, 15 people with autoimmune diseases received Cartesian CAR T therapy; Two-thirds saw their symptoms improve, and no one was sick for a long time.

Treatment of shock for CAR T cells

Beyond side effects, another major challenge facing CAR T therapy is its cost, which runs into the hundreds of thousands of dollars including hospitalization, stem cell processing, and other costs.

The treatment could be cheaper, and easier, if scientists could eliminate the need to create a machine for each patient’s own cells and instead use donor cells, or if they could cut out the engineering part and grow the cells in the laboratory. Lunning says he’s looking at emerging techniques that can modify a person’s T cells within their own body rather than genetic engineering in a lab.