A Direct Infusion Of Immune Cells Could Fight Cancer

 Micrograph of a glioblastoma

Injecting genetically modified immune cells directly into the brain and spinal fluid has had remarkable effects on a deadly brain cancer 

Glioblastoma is a particularly virulent form of brain cancer. Around 20,000 people in the United States are diagnosed each year and the disease typically has poor survival rates. In a new case reported in the New England Journal of Medicine, a man has undergone experimental CAR-T therapy to treat the condition. CAR-T therapy is a branch of immunotherapy, the field taking cancer treatment by storm, and involves infusing genetically modified T cells back into a patient to target cancer cells. 

A new hope

50-year-old Richard Grady received the treatment in California, and it involved dripping these specialised cells through a narrow tube into the brain. CAR-T therapy (also called chimeric antigen receptor) involves adding novel receptors on the surface of T cells; allowing them to better recognise and destroy any cancer cells they come across. Grady's therapy began with surgery to remove 3 larger tumours, and then followed with 6 weekly infusions into the brain. 

Unfortunately new tumours had begun to form in different regions including the spine, so the research team decided to target a new area for delivery - the region in which spinal fluid is churned out and then distributed 

T cells attacking a target. Credit: N. Dieckmann, Griffiths Lab, Cambridge Institute for Medical Research. Wellcome Images

"The idea was to have the flow of the spinal fluid carry the T cells to different locations"

After 3 infusions the tumours were markedly shrunk, and by 10 they were essentially gone; allowing Grady to return to work and cut back on additional medicine. 

How effective could this therapy be? 

The treatments allowed the patient to live over a year and a half so far, when a typical survival period can number in  mere weeks. While new tumours have now come back, the immunotherapy response following treatment lasted for 7 months, which is extremely encouraging. Dr. Donald O'Rourke, a neurosurgeon at the University of Pennsylvania, is now heading a similar research study involving 10 similar patients. We will have to await further results to see how effective this updated strategy is, although is. Immunotherapy often works well for some patients, and has little effect on others. 

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