December 12, 2023

Alternative Uses and Indications for CAR-T Cell Therapy

Kevin Conard
Kevin Conard


Chimeric Antigen Receptor (CAR-T), T-cell therapy has primarily been developed and approved for the treatment of blood-borne cancers,particularly certain types of leukemia and lymphoma. However, researchers are exploring its potential in various other areas as well. CAR-T cell therapy has been described as a living drug where when one cell finds its target it can divide into millions or even billions of cells to attack disease and prevent it from coming back. This is possible because live CAR-T cells persist in treated patients for a decade or more, keeping them immune from a recurrence, making this therapy truly a living drug.

CAR-T cell therapies are beginning to make inroads into treating solid tumors cancers. While CAR-T therapy's initial success has been in blood cancers, researchers are investigating its application in solid tumors, such as breast, lung, pancreatic, and ovarian cancers. Solid tumors present unique challenges due to the complex tumor micro environment and antigen heterogeneity, but efforts are ongoing to develop CAR-T constructs that can target solid tumor antigens effectively.

CAR-T cells can also be engineered to target and suppress specific immune responses involved in autoimmune diseases like rheumatoid arthritis or lupus. By targeting the immune cells responsible for creating the antibodies eliciting the autoimmune reaction, the CAR-T therapy gets to the root of the disease and silences it without impacting the immune system.

This therapy is also being investigated as a potential treatment for viral infections such as HIV and hepatitis B and C. The idea is to engineer T cells to target and destroy cells infected with the virus. While this area of research is still in its initial stages, it holds promise for addressing persistent viral infections.

CAR-T cell therapy not only can be used to treat disease but may also show promise in aiding the repair of tissue post injury. Groundbreaking work is being done at the University of Pennsylvania in the Epstein Lab where CAR-T cells show promise in destroying the fibrous scar tissue that forms after a heart attack, thereby making the restoration normal function possible. This research is in its initial stages, but being able to treat the underlying problem of scar tissue formation that prevents normal heart function would be a game changer.

Understanding the science is the first hurdle in making all of these indications available to patients. The second is the ability to manufacture these cells at scale. Historically these cells needed to be manufactured by highly trained and skilled scientists, creating a workforce bottleneck in the ability to meet the demand. One method of addressing this issue is through automation. Biopharma companies are working on systems that would completely automate the process, from patient samples to CAR-T cells, not only addressing the manufacturing bottleneck, but also minimizing human error, and improving reproducibility.

It is important to note that while these potential applications are being explored, many of them are still in the preclinical or early clinical stage trials. The field of CAR-T therapy is rapidly evolving,and researchers are working to address challenges related to safety,specificity, and efficacy for each new application.

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