Current and Future Approaches to Immunotherapy

Immunotherapy is treatment that uses parts of a person’s immune system to fight diseases. This can take the form of stimulating the natural effects of a patient’s immune system so that it works harder and smarter to attack cancerous cells. In the last few decades, immunotherapy has played an important role in the treatment of some cancers. While many treatments in the field of immunotherapy have just begun to emerge, the future is proving to be quite promising.

Current Approaches to Immunotherapy 

CAR T-cell Therapy 

CAR T-cell therapy is a type of adoptive cell therapy (ACT), which collects and utilizes a patient’s own immune cells to fight their cancer. As the name suggests, CAR T-cell therapy is dependent upon a patient’s T-cells, which play a critical role in managing the immune response and killing cells affected by harmful pathogens. These pathogens have unique antigens (markers) and T-cells are genetically equipped with receptors designed to identify and eliminate these harmful cells. CAR T-cell therapy harnesses the antigen-recognition power of the patient’s T-cells and reengineers them to target and kill cancerous cells. 

For decades, CAR T-cell therapy was restricted to small clinical trials, but in recent years, it has been approved by the Food and Drug Administration (FDA) for cancer treatments. Currently, there are four FDA-approved therapies:

• Kymriah – approved for the treatment of children and young adults with B-cell acute lymphoblastic leukemia (ALL)

• Yescarta – approved for the treatment of adults with diffuse large B-cell lymphoma (DLBCL)

• Tecartus – approved for the treatment of advanced mantle cell lymphoma (MCL)

• Breyanzi – approved in February 2021 for the treatment of adult patients with relapsed or refractory large B-cell lymphomas

These therapies have proven to be effective, with an overall patient response rate of 83 percent. 

CAR NK Therapy 

Natural Killer (NK) cells are lymphocytes in the same family as T and B cells, coming from a common progenitor. Progenitor cells are descendants of stem cells that can further differentiate to create specialized cell types. NK cells are best known for killing virally infected cells, and for the detection and control of early signs of cancer. The name, “natural killer,” comes from the cells’ ability to kill cancerous cells without any priming or prior activation (as opposed to T-cells, which require priming by antigen presenting cells). NK cells originate from hematopoietic stem cells, and the bone marrow is considered the primary site of NK development. These cells are extracted from the patient, and engineered to express antigen-specific chimeric antigen receptors (CARs) for better recognition and killing of tumor cells. CAR NK therapy is viewed as an alternative to CAR T-cell therapy, as it circumvents some of the challenges that CAR T-cell therapy faces. Specifically, CAR NK therapy has the ability to be used as an unlimited allogeneic NK source (rather than being donor-dependent, the cells will come from the patient receiving the treatment), has a relatively shortened production time, and the recognition and killing of tumor cells through NK cell native receptors is independent of CAR engineering. 

As of the date of this post, there are no FDA-approved CAR NK therapies. There are, however, 27 CAR NK therapy clinical trials registered in the U.S. National Library of Medicine. Recently, one of those trials reported a 73% response rate in patients with leukemia and lymphoma. 

Dendritic Cell Therapy 

Dendritic cells are responsible for the initiation of adaptive immune responses. Named after their “tree-like,” or dendritic shapes, they can reside in organs or migrate among the lymphoid and nonlymphoid organs of the body. As the guardians of the immune system, Dendritic Cells (DCs) concurrently capture antigens and pathogens, process them and then present them to other cells in the immune system (B and T cells) in order to stimulate a T-cell response. They are derived from progenitor cells in the bone marrow and are considered professional antigen presenting cells (APCs) because they are the most potent type of antigen-presenting cells in the immune system. Dendritic cell therapy can be thought of as a cancer vaccine made from your own blood. A patient’s dendritic cells are modified to correctly identify cancerous cells, then introduced back into the patient, boosting their body’s capacity to fight the cancer. This creates a therapy by which the patient’s body battles the cancerous cells with its own, boosted immunity. 

There are currently 50 active clinical trials involving dendritic cell therapies in humans. Data from this research is not yet available. However, results from animal studies have provided promising results that have given medical professionals confirmation of their viability as a treatment for cancer. 

The Future of Immunotherapy 

Advances in research have increased scientists’ and medical professionals’ understanding of immune system regulation and created a foundation for expansion in immunotherapy. One approach to improving the effectiveness of immunotherapy may be combining immunotherapy with other, currently established treatments. For example, combining immunotherapy with chemotherapy or radiation for the treatment of cancer. 

Another option is to combine two or more immunotherapies, giving patients a combination of vaccines. The first vaccine would prime the immune response to tumor antigens, and the second would act as a booster. 

While this field of medicine has made tremendous strides in recent decades, much work remains to be done to refine strategies and practices before they can be implemented into routine clinical practice. 

How ThermoGenesis Can Help 

ThermoGenesis Holdings Inc., is a pioneer and market leader in the development and commercialization of automated cell processing technologies for the cell and gene therapy fields. We market a full suite of solutions for automated clinical biobanking, point-of-care applications and large-scale cell processing and manufacturing with a special emphasis on the emerging CAR-T immunotherapy market. We are committed to making the world a healthier place by creating innovative solutions for those in need. 

For more information on the CAR-TXpress™ multi-system platform, please contact us.