Immunotherapy is unleashed on blood cancers

Tomas Sandoval was about to become a father for the second time in June 2014, when he was devastated to learn he had non-Hodgkin lymphoma, a type of cancer that starts in the white blood cells. The College Station, Texas, resident underwent a stem cell transplant at MD Anderson that kept his disease in check – for a year.

In June 2015, doctors discovered a large chest mass that revealed Sandoval’s cancer had spread. With few options left, he joined a clinical trial testing CAR-T cell therapy for the treatment of lymphoma. Led by Sattva Neelapu, M.D., professor of Lymphoma and Myeloma, the study is the first multi-center trial of its kind for lymphoma.

How it works

In CAR-T therapy, a person’s own T cells – disease-fighting immune cells – are removed and sent to a lab where they are genetically re-engineered to produce chimeric antigen receptors (CARs) on their surface. CARs are proteins that allow T cells to recognize cancer.

The CAR T cells are then multiplied in the laboratory until there are millions. Next, they’re sent to the hospital and infused back into the patient’s bloodstream. These “attacker” cells not only recognize and kill cancer cells, but they may remain in the body long after the infusion has been completed and guard against cancer’s recurrence.

CAR-T cell therapy is part of a growing field of cancer treatment called immunotherapy, a broad term that covers a range of treatments that harness patients’ immune systems to fight cancer. Other forms of immunotherapy to treat cancer include monoclonal antibodies, which are designed to attach a very specific part of a cancer cell; vaccines, which stimulate an immune response against cancer; and immune checkpoint inhibitors, which take the “brakes” off the immune system so it can recognize and attack cancer cells.

Immunotherapy has proven successful in many cancers such as melanoma, lung and kidney cancer, and Hodgkin lymphoma with several drugs already FDA-approved. And with more than 65 trials underway to test immunotherapy’s effectiveness in battling blood cancers such as chronic lymphocytic leukemia, myelodysplastic syndrome, non-Hodgkin lymphoma and acute myeloid leukemia, MD Anderson is considered a leader in the field.

“Most major cancer centers have two or three leukemia trials using immunotherapy,” says Naval Daver, M.D., associate professor of Leukemia. “We have more than 15, and are very much out front. It’s an exciting area of study and we are seeing some encouraging results in patient responses.”

MD Anderson is conducting several dozen clinical trials involving investigators from multiple departments, programs and other institutions and companies that are studying various immunotherapy agents for blood cancer. Learn more about these trials in Conquest magazine.