An immunotherapy has frozen the progress of multiple myeloma in terminal patients for five years. Suggesting a potential hope of care.
An experimental treatment based on Car-T cells allowed the control of long -term disease In patients with Multiple myelomaa blood cancer considered incurable so far. Immunotherapy has succeeded in the “impossible” company to reactivate the immune system of the participants, exhausted from years of oncological treatments without result, and induce him to fight the tumor.
More than five years after the (single) infusion, a third total of patients returning from therapy was free from signs of progression of the disease, without maintenance treatments. So much so that some expert oncologists in the sector go to speak of the thing closest to a cure never touched in decades of research. The results of the Trial were presented on Tuesday 3 June at the Annual Conference of the American Society of Clinical Oncology (ASCO) and published on Journal of Clinical Oncology.
Multiple myeloma: what it is and what the symptoms are
Multiple myeloma is the most frequent blood cancer after lymphomas. Involves abnormal and disordered growth of plasma cellscells of the immune system deriving from B lymphocytes and in charge of producing antibodies. The plasma cells are found in the bone marrow, a spongy tissue contained especially in the ends of the long bones and inside the flat bones (such as those of the pelvis and the ribs).
The abnormal proliferation of plasma cells causes the production of clones of the same type of antibody and suppresses that of other fundamental elements such as white blood cells, red blood cells and platelets. It also reduces the creation of defensive antibodies. In addition to this, tumor plasma cells can degenerate into bone tumors or secrete substances that cause the Destruction of bone materialfor example at the level of the pelvis, the spine and the skull.
Among the symptoms of multiple myeloma there are severe bones pains, fractures, immunocompromission, renal failure and a strong weakness for the reduced production of red blood cells. Despite the progress in therapies, multiple myeloma is an incurable form of cancer and the therapies available, based on various combinations of drugs (including chemotherapy and monoclonal antibodies) mainly aim to slow down his progression.
Car-T against myeloma: the new study
The new therapy called Carvykti and developed by the Chinese Biotech Legend is based on the Car-T (Chimeric Antigens Receptor Cells-T- to learn more). Take advantage of the T lymphocytes of the patient, taken, engineered to attack cancer cells and therefore reinfusi. He had already been tested on people with forms of resistant myeloma already at least a form of treatment, with encouraging results in the lengthening of survival.
In the new trial it was administered to 97 patients at the Termoma terminal stadium, returning from years of treatments, with the disease in progression and the immune system weakened by the tumor and treatments received.
It was not obvious to be able to awaken their defenses and arm them against myeloma.
But, for a third of them, it worked: five years after the single infusion of Car-T which took place between 2018 and 2019, 33 patients were alive and without signs of progression of the disease, without having received other treatments against myeloma in the meantime. Usually, the average survival time of patients in those same conditions is about a year.
Of the progression free patients, 12 have undergone serial assessments of the minimum residual disease (MRD), that is, to analysis to evaluate the presence in the body of a small residual number of cancer cells that could cause recurrence. The search for these cells gave negative outcome: the tumor seemed to have disappeared, “suggesting a potential healing or, at least, an unprecedented duration of the complete response”.
A potential “care” against myeloma?
The study was financed by the US pharmaceutical company Johnson & Johnson, who with Legend Biotech has entered into an exclusive license agreement of the drug. Car-T has important limits in debilitating side effects and in costsstill prohibitive, but the next step will be to test the administration in patients in more early stages of the disease, to understand if it can represent a real possibility of treatment. A word that if it was once an unrealistic perspective for patients with myeloma, now it seems to be at least one that can be grasped.
