FDA Approves Clinical Testing of CAR T-cell Therapy for MBC

42young

https://breastcancer-news.com/2019/07/26/fda-approves-clinical-testing-minervas-car-t-cell-therapy-metastatic-breast-cancer/

skyfly

This seems so exciting!

Cure-ious

Progress!! Combined with the booster vaccine we heard about last month -- let's see how well this works!

pajim

Excellent. As an ER+ patient I'm hoping they don't exclude us. Usually they do because it's easier to show efficacy in triple negative. [I'm happy for them, unhappy for me ;-) ]

Of course it'll take 6 months to set up the trial and get it through the IRBs, but sometime next year. . .

skyfly

pajim, what are IRBs?

Moomala

This articlesays that Minerva Technologies intends to begin clinical trials before the end of this year. I sure hope so!

WC3

I'm not stage IV but I just want to say I'm so happy this is advancing. We hear of so many promising treatments that nothing ever comes of; "Blah blah blah cured cancer in mouse models" and it never leaves the lab; it's disillusioning. I hope this CAR-T therapy really pans out.

skyfly

https://www.wired.com/story/how-scientists-built-living-drug-to-beat-cancer/?verso=true

Interesting article about the history of CAR-T therapy. Apparently T cells were only identified in the 60s.

skyfly

I hope I dont get in trouble for advertising, but this is the book the article is based on. I've ordered and will update you all with if its worthwhile:

The Breakthrough: Immunotherapy and the Race to Cure Cancer

JFL

Sounds promising. I hope this one gives us a good option in the future. Interesting that 95% of breast cancers harbor the MUC1 protein this trial therapy will be targeting. That is a good stat for all of us! I haven't ever had any proteins tested in relation to my BC.

BevJen

If I'm not mistaken (and I may be) I think that the CA 27-29 tumor markers test shows evidence of MUC1 -- I think that's the basis of the test? If I'm wrong, someone more knowledgeable please correct me.

Cure-ious

Interesting to see in the literature that the MUC1 over-expression has been a known feature of breast cancers for quite a long time but they did not have a way to target it- it is high in triple-negative (95%) but also in breast cancer generally (90%) and they indicate that the levels are higher still in cells that have become endocrine-resistant or paclitaxel-resistant, ie the levels of MUC1 increase as the cancer becomes more aggressive. Hopefully, the CAR-T trials will be open to both ER-positive and triple-negative breast cancers.

ann273

Another bit of exciting news today https://xconomy.com/new-york/2019/07/29/merck-data-are-another-step-for-immunotherapy-in-breast-cancer/, but it seems like the Phase 3 trial was only for triple negative breast cancer. I wish trials would extend to Er+ve patients as well. How would we know whether it works or not if we dont even try

DivineMrsM

Not to rain on the parade, but in reading the reviews for the book that skyfly mentions which outlines this treatment, there are still many risks, side effects and outcomes for this procedure. Yes, I love that it is a promising new way to treat mbc, but I want to see the whole of it for what it really is. I plan to check if I can get the book from my library to read.

pajim

IRB = Institutional Review Board, or in the rest of the world, "Ethics Committee". It's a long long story but institutions (hospitals in our case) must approve a study before it can start. If you're doing the study in 10 hospitals, that's 10 ethics committees. Each of whom want something different. This is slowly changing but for right now that's how it works.

DivineMrsM is right about the therapy. It's still a 'hail mary' type treatment. This is the treatment that causes cytokine storm, puts people into the hospital for weeks, etc. without being at all sure it will work. There are two kinds -- the one where they take your blood and design new cells, and the one [which I think they are doing here] where they just give new cells.

It has been tried in some leukemias and lymphomas.

But I am not so far off from being willing to try a Hail Mary. Still well enough to withstand the effects but with few treatments left.

skyfly

thanks pajm for the explanation!

I read a few articles recently about repurposing a leukemia treatment for cytokine storms. Hopefully they pan out and this won’t have to be a hail mary for long

https://www.mskcc.org/blog/drug-hits-car-snooze-button-can-quiet-cytokine-storm

https://singularityhub.com/2019/07/10/cancer-killing-living-drug-is-made-safer-with-a-simple-off-switch/

skyfly

I find immunotherapy articles regularly and never know where to post them, so I'm going to leave them here until someones tells me not to. The below are from a study out of Mount Sinai for Non-Hodgkin's lymphoma which is another solid tumor,

https://www.healtheuropa.eu/immunotherapy-drugs-lymphoma/92707/

https://finance.yahoo.com/news/mount-sinai-researchers-immunotherapy-treatment-183000406.html

From the article:

This type of immunotherapy, called "checkpoint blockade," ramps up the ability of immune cells called T cells to fight cancer by removing the "cloaking effect" that tumors use to hide from them. Checkpoint blockade therapy is effective in several tumor types, but generally ineffective in non-Hodgkin's lymphomas. However, the study found that when this immunotherapy is combined with a stem cell transplant, which the researchers call "immunotransplant," the process ramps up the T cells to increase the cancer-killing immune response tenfold, allowing it to be effective for non-Hodgkin's lymphoma and more successful for melanoma and lung cancer.

Cure-ious

Thanks, Sky!!

I hope your mom is having a fun summer and still getting clean scans!!

skyfly

Hi Cure-ious, she is having fun! Her uncle came to visit from overseas for three months. I was worried she'd be down when he left, but she's started going to the gym and is staying very active. Scans coming up in a month or so, fingers crossed. Hope all is well with you

Do you understand why this "immunotransplant" would increase the ability of the T cells to penetrate the otherwise cold tumor?

Cure-ious

doing good, Skyguy!!! I guess it reduces the tumor cell burden before coming in with the new T cells, which would make sense for blood-borne cancers- however they also think this will work for solid tumors, so there must be more to it...

Cure-ious

More good news in research- the stuff we discuss here doesn't even begin to cover it all, folks!

Here is a recent Nature paper showing that loss of p53 drives breast cancer metastasis by turning on the Wnt signaling pathway, a pathway normally only active in early development, but gets re-activated in many cancers. Inhibitors of Wnt signaling block metastasis and inflammation driven by this pathway

https://www.nature.com/articles/s41586-019-1450-6

Another report identifies some peptides that can inhibit Wnt signaling, and they show that not only do these peptides block cancer growth, but they also increase T cell infiltration into the tumor. Thus inhhibitors of Wnt signaling should also boost immunotherapy.

https://advances.sciencemag.org/content/5/5/eaau52...

skyfly

whooot! Fascinating study. This definitely stretches my limited knowledge of life sciences. I’ve learned more about antibodies and T cells than i ever wanted to.

non-hodgkins lymphoma is a solid tumor, right?

I hope that they start doing more studies where they couple these immuno-boosters together.