A breakthrough in Hemo-Oncology

Dr. Colin Philipps Diong, Senior Consultant Hematologist at the Parkway Cancer Center Singapore, together with Dr. Ang Peng Tiam, Consultant Medical Oncologist describe CAR T-Cell as a revolutionary therapy in the field of hemo-oncology. 

Targeted agents are coming into play, as not everybody requires or responds to chemotherapy. Fighting cancers by modifying Genetic studies are important. And a billion-dollar research later, CAR T-Cell therapy is now the latest breakthrough.

Chemical medications aka chemotherapy, and radiation therapy have been used to combat cancer for some time now. Targeted agents that target certain cell receptors and antibodies were then introduced. Chimeric Antigen Receptor T- Cell therapy, known as CAR T-cell therapy has been built on the concept of modifying our own immune cells to attack the cancerous cells.

What are T cells? 
T Cells are a type of white blood cells also known as T lymphocytes. These T cells are an integral part of the immune system. However, T cells are NOT naturally equipped to interact with cancer cells. 
When T cells are modified to target cancer cells, they become CAR T Cells, and now these T cells become equipped to handle cancer. This new technology opens a whole new world of possibilities in the world of cancer treatments.

How is this done?
T cells are extracted from the patient, in a similar way stem cells etc., are extracted from the bone marrow. This procedure is called “apheresis” where only the required cells are taken from patient’s blood, sparing the others. These extracted T cells are ‘cryo-preserved’, meaning, frozen in extreme temperatures and sent to the gene laboratory in the USA. The T cells are then processed and CAR T cell molecule is made. These modified cells are brought back to the patient, and now these new cells will have the capacity to target and possibly destroy the cancer cells. This new milestone in cancer treatment brings hope to many patients who have leukemia that is resistant to other forms of treatment.

The first patient to combat leukemia with CAR T Cell therapy entered the research as a five-year old. She had a resistant form of acute lymphoblastic leukemia (ALL), and was suggested palliative care with mere months to live. At age 12, CAR T cells were introduced into her system, after CAR T cell therapy was approved by the FDA (Food and Drug regulation authority) in the USA, in 2017. The treatment has proven to be effective for this patient, who has been thriving since, despite being given months to live as a child.

This therapy is indicated for patients who have a type of blood cancer called ‘relapsed B-cell acute lymphoblastic leukemia’, and for patients who have a ‘relapsed diffuse large B cell lymphoma’.

By the end of 2022, the researchers are hoping to get  CAR T cell therapy approved for a type of cancer called ‘relapsed multiple myeloma’. 

Parkway Cancer Center Singapore has opened up a new portal of possibilities to patients who have resistant blood cancers. CAR T cell therapy being a relatively new area of cancer treatment, challenges are indeed present.

However, this new treatment modality brings us one step closer to hope. Patients from all over the world have access to the Parkway Cancer Center Singapore, via canHOPE centers located globally. For further information, Parkway Cancer Center – Colombo, which is located in Nugegoda can be contacted. More information can be found in their website www.parkwaycancercentre.com, where one can find resources most useful to cancer patients, their families and loved ones.