New Weapons in Fight Against Cancer
CAR T-cell therapy, gene testing can help beat this deadly disease
Marge Jaques battled non-Hodgkin’s lymphoma for 15 years, but the white blood cell cancer kept coming back despite multidrug chemotherapy cocktails, liquid radiation and even stem cell therapy. “It returned every two years. In 2014 I had lumps all down my neck, because there were tumors in my lymph glands,” says Jacques, now 63. “I cried as I drove to see my oncologist in Philadelphia. Then he told me there was something new to try.”
Jacques became one of the first American adults to get CAR T-cell therapy — the nation’s first personalized cellular cancer treatment — for her specific cancer, diffuse large B-cell lymphoma. The treatment removed some of her T cells, which are the immune system’s frontline killers. The cells were then genetically modified to produce a receptor that will attach to cancer cells and attack them.
Miraculously, Jacques’ cancer went into remission. “Slowly, the tumors shrank. Blood tests and scans showed it was gone,” she adds. Even better: It has not returned, and she is back to enjoying life. “Throughout my years with cancer, I never felt sorry for myself. But it’s a rocky road,” says this single mother and project manager from Collegeville, Pa. “Humor, family and friends got me through all this.”
Today the groundbreaking treatment is available commercially. In October 2017 and May 2018, the Food and Drug Administration (FDA) approved two CAR T-cell drugs for patients such as Jacques, whose diffuse large B-cell lymphoma doesn’t respond to other treatments. Experts expect that these drugs, which are covered by Medicare, will be deployed against a variety of cancers in the future. “This is a spectacular new therapy,” notes Jacques’ oncologist, CAR T-cell researcher Stephen J. Schuster, director of the lymphoma program at the University of Pennsylvania. “It’s saving the lives of people whose prognosis was measured in months, not years. In studies, 50 percent respond and about 1 in 3 are long-term, disease-free survivors.”
ON THE HORIZON
Q: What recent advances are you excited about?
A: From August 2017 through July 2018, the FDA approved 14 new anticancer therapeutics. These include nine molecularly targeted therapeutics, part of the new wave of precision medicines, as well as two targeted forms of radiotherapy and two new CAR T-cell therapies. There are preclinical studies of vaccines that target oncogenes (early genetic changes that initiate cancers). We expect to see these tested in the next few years in individuals who are at high risk for cancer development."
Mega Gene Test Checks for Targeted Cancer Treatment
Designated a breakthrough by the FDA when it was approved in late 2017, FoundationOne CDx is one-stop shopping for gene-based treatments. Just one test can check for mutations in 324 genes involved in cancer growth, allowing oncologists to identify the most promising treatments quickly. The FDA recently approved a similar test from Memorial Sloan Kettering Cancer Center in New York City; it’s called MSK-Impact, and it looks for mutations in 468 genes.