T-cell transfer therapy empowers your immune cells to fight cancer more effectively. This advanced immunotherapy involves collecting your immune cells, enhancing them in a laboratory, and reintroducing them into your body to target and destroy cancer cells. This therapy comes in two main forms: tumor-infiltrating lymphocytes (TIL) therapy and CAR T-cell therapy. Both methods involve collecting T cells (a type of immune cell) from your body, enhancing them in a laboratory, and reintroducing them to target and attack cancer cells more effectively. This approach is also known as adoptive cell therapy, adoptive immunotherapy, or immune cell therapy.
The T-Cell Transfer Process
- Collection and Lab Enhancement: Doctors extract T cells from your body to prepare them for therapy. In TIL therapy, they focus on T cells within the tumor, testing them to find the ones most effective at recognizing tumor cells. They then multiply the best-performing T cells rapidly in the lab. In CAR T-cell therapy, doctors modify your T cells genetically to produce a specialized protein called a chimeric antigen receptor (CAR), enhancing their ability to target and destroy cancer cells. CARs help T cells attach to specific proteins on cancer cells, enhancing their cancer-fighting capabilities.
- Preparatory Treatment: During the 2 to 8 weeks required to grow T cells in the lab, you may receive chemotherapy and sometimes radiation therapy. These treatments suppress other immune cells, creating a more favorable environment for the enhanced T cells to work effectively.
- Reintroduction: The enhanced T cells are reintroduced into your body via intravenous infusion. These cells then seek out and destroy cancer cells.
Image resource: Hollings Cancer Center
TIL Therapy vs. CAR T-Cell Therapy
- TIL Therapy: Uses naturally occurring tumor-fighting T cells found within or near the tumor. These cells are multiplied in large numbers to boost their ability to combat cancer.
- CAR T-Cell Therapy: Genetically modifies T cells to produce CAR proteins, enabling them to attach more effectively to cancer cell proteins and enhance their destructive capability.
Cancers Treated with T-Cell Transfer Therapy
- TIL Therapy: The FDA has approved lifileucel (Amtagvi) for treating melanoma. It shows promise for cervical squamous cell carcinoma and cholangiocarcinoma, although it remains experimental for these cancers.
- CAR T-Cell Therapy:
- Six FDA-approved CAR T-cell therapies treat blood cancers, such as:
- Axicabtagene ciloleucel (Yescarta)
- Brexucabtagene autoleucel (Tecartus)
- Ciltacabtagene autoleucel (Carvykti)
- Idecabtagene vicleucel (Abecma)
- Lisocabtagene maraleucel (Breyanzi)
- Tisagenlecleucel (Kymriah)
- CAR T-cell therapy is also being studied for use in solid tumors, including breast and brain cancers, though these applications are still experimental.
- Six FDA-approved CAR T-cell therapies treat blood cancers, such as:
Potential Side Effects of T-Cell Transfer Therapy
Like any medical treatment, T-cell transfer therapy can cause side effects that vary depending on individual health, cancer type, treatment stage, and dosage. Common side effects include:
- Cytokine Release Syndrome (CRS): This side effect, associated with CAR T-cell therapy, occurs when T cells release a surge of immune-signaling molecules called cytokines into the bloodstream. Symptoms include fever, nausea, headache, rash, rapid heartbeat, low blood pressure, and trouble breathing. While most cases are mild, severe instances can be life-threatening.
- Targeting Normal Cells: CAR T cells may occasionally recognize and attack normal cells, causing organ damage or other complications.
- Capillary Leak Syndrome: Seen with TIL therapy, this condition occurs when fluids and proteins leak from tiny blood vessels into surrounding tissues, leading to dangerously low blood pressure, organ failure, or shock.
The Future of T-Cell Transfer Therapy
T-cell transfer therapy represents a groundbreaking approach to treating cancer. Researchers continue to refine these techniques, aiming to expand their use for solid tumors, enhance safety profiles, and improve patient outcomes. By harnessing the power of the immune system, this innovative therapy provides new hope for patients with challenging cancers.
Resource: Cancer.gov
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